Transesophageal echocardiography: A comprehensive assessment of the critically ill patient

Transesophageal echocardiography (TEE) has become an essential tool in the management of critically ill patients, particularly when transthoracic echocardiography is insufficient. Its use allows to obtain high-quality imaging to assess cardiac function, diagnose the cause of shock, monitor fluid responsiveness, and evaluate venous congestion. It is especially valuable in complex scenarios such as stroke, the postoperative period after cardiac surgery, ECMO support, and during cardiac arrest, as it provides continuous visualization without interrupting chest compressions. Although it is a semi-invasive technique, it has a very favorable safety profile when performed by trained intensivists. Adequate training, including supervision and simulation, is crucial for achieving competence. Besides, TEE allows the examination of pulmonary and abdominal structures, extending its utility beyond the heart. Its incorporation into Intensive Care Medicine has demonstrated significant clinical impact, modifying therapeutic management in a high proportion of patients.