USEFULNESS OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE TREATMENT OF CRITICALLY ILL PATIENTS

To evaluate the usefulness of transesophageal echocardiography (TEE) i n the treatment of critically ill patients, 80 patients (51 male and 2 9 female; mean age, 53 years) undergoing both transthoracic echocardio graphy (TTE) and TEE were studied in a 2-year period. Of these, 48 pat ients were studied in the ICU, while the other 32 patients were direct ly referred from the emergency departments. Indications for the study included suspected aortic dissection (34 patients), hemodynamic instab ility (22 patients), suspected cardiac source of embolism (11 patients ), evaluation of the severity of mitral regurgitation (7 patients), an d suspected infective endocarditis (6 patients). The probe was passed successfully in 78 of 80 attempts (98 percent). No significant complic ations were recorded during the transesophageal echocardiographic stud y. Transesophageal echocardiography provided critical information that was not obtained by TTE in 39 of 78 studies (50 percent, p<0.005). Ca rdiac surgery was prompted by TEE findings in 14 patients (18 percent) and these findings were all confirmed at operation. Transesophageal e chocardiography was a safe, well-tolerated, and valuable diagnostic ap proach for the rapid detection of specific cardiac abnormalities in pa tients with critical illness; TEE should be considered in the treatmen t of critically ill patients especially when TTE provided inadequate i nformation.