Use of transesophageal echocardiography in burns:a retrospective review

Transesophageal echocardiography (TEE) is a useful tool in the evaluation and management of critically ill patients. However, it has not been studied in the burn population. The purpose of this review is to describe the safety and utility of TEE in the management of acute burns. This retrospective review included all acute burn inpatients who underwent TEE during a 5-year period at our regional burn center. TEE board-certified anesthesiologists performed all studies. We reviewed the chart of patients who underwent TEE, the indication for TEE, the effect of TEE on clinical management, and complications resulting from TEE. Seventeen burn patients underwent TEE during the review period. The median age was 45.4 years. Fourteen of 17 patients were men (82%). Median TBSA burn was 43.4%. Seven patients (41%) were on vasopressors or inotropic agents at the time of TEE. The main indications for TEE were hypotension and bacteremia. Findings included hypovolemia, mitral valve vegetation, pulmonary hypertension, pericardial effusion, fluid overload, right heart failure, and normal TEE. Therapeutic changes occurred after TEE in two patients; these included initiation of inotropic support and antibiotics. There were no complications identified in association with TEE. TEE is a safe procedure that serves multiple diagnostic purposes. TEE is being used to better understand the fluid status and cardiac physiology of the critically ill burn patient.