Changing patterns of transesophageal echocardiography use in the intensivecare unit

Since its advent, the use of transesophageal echocardiography (TEE) has gro wn rapidly. In. patients undergoing TEE in the intensive care unit over two time periods (4 years apart), we evaluated whether TEE led to new/unsuspec ted findings or changes in, patient management. Results showed that the ind ications for which patients underwent TEE changed considerably between the two time periods. Hemodynamic instability was an indication, for TEE in 41% of the patients in the first interval and 56% of the patients in the secon d interval. TEE frequently established a new diagnosis (41%) and Led to sig nificant management changes (28%) in both time periods. These changes occur red despite the use of a pulmonary artery catheter in, nearly 2/3 of the pa tients studied. Therefore, despite increasing and changing use, TEE frequen tly establishes unsuspected diagnosis and directly influences patient manag ement when used in intensive care patients.