Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography

Area of Science:

• Critical Care Medicine
• Point-of-Care Ultrasound
• Echocardiography

Background:

• Focused transesophageal echocardiography (TEE) is increasingly utilized in critical care.
• Its clinical impact and safety in diverse emergency and intensive care unit (ICU) settings require thorough evaluation.

Purpose of the Study:

• To assess the clinical effectiveness, safety, and outcomes of focused TEE in critically ill patients.
• To evaluate the influence of point-of-care TEE on patient management in emergency departments (EDs) and ICUs.

Main Methods:

• A prospective, multicenter, observational registry of adult critically ill patients undergoing focused TEE.
• Inclusion criteria covered out-of-hospital cardiac arrest (OHCA), in-hospital cardiac arrest, undifferentiated shock, hemodynamic monitoring, and procedural guidance.
• Data collected included patient demographics, procedure details, lab values, interventions, outcomes, and TEE images.

Main Results:

• 1,045 focused TEE studies were analyzed from 916 patients across 28 hospitals.
• Management changes occurred in 85% of undifferentiated shock cases, 71% of in-hospital cardiac arrest, and 62% of OHCA.
• No esophageal perforations or oropharyngeal injuries were reported; other complications were infrequent.

Conclusions:

• Focused TEE is a safe and clinically impactful tool in various critical care scenarios.
• The established registry facilitates further research into TEE's role in emergency and critical care.
• Future studies will focus on outcome-oriented research and knowledge translation for TEE application.