EVALUATION OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY AS A DIAGNOSTIC AND THERAPEUTIC AID IN A CRITICAL CARE SETTING

Objectives: To assess the impact of transesophageal echocardiography ( TEE) on therapeutic management in relation to pulmonary artery cathete rization (PAC) in the ICU. Design: Retrospective analysis of 108 conse cutive TEE video and related patient files during a 7-month period. Se tting: A 33-bed medical and surgical ICU. Methods: All critically ill patients with or without PAC in whom a TEE was performed, excluding po stoperative cardiac surgical patients. Patients were divided in a card iac and a septic group depending on the primary disease on admission t o the ICU. The impact of TEE in relation to PAC on ICU management was evaluated in whether therapy changes were performed strictly on the ba sis of the TEE findings. Main results: Of 64% of patients with a PAC, 44% underwent therapy changes after TEE: 41% in the cardiac and 54% in the septic subgroup. In 41% of patients without a PAC, TEE led to a c hange in therapy. Conclusions: TEE results in altered therapeutic mana gement in at least one third of our (noncardiac surgery) ICU patient p opulation independent of the presence of a PAC.