Abstract 273: Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography
Felipe Teran, Clark G Owyang, Trenton Wray, John Hipskind, Justine Lessard, William Bédard Michel, Chantal Lanthier, Peiman Nazerian, Eleonora de Villa, Jonathan Nogueira, Daniel Doynow, Michelle Clinton, Frank Myslik, Ross Prager, Robert Arntfield, Pedro D Salinas, Vladyslav Dieiev, Michael Y Woo, Rajiv Thavanathan, Graeme Puskas, Karan Singh, Priyanka Bhat, Jackson Horn, Brian M Buchanan, Nadia Baig, Katharine Burns, Kelsey Kennedy, Lawrence Haines, Leily Naraghi, Harpriya Singh, Michael Secko, Daniel Singer, Maria Taylor, John M Joyce, Stephanie DeMasi, Zan M Jafry, Tammy Phan, Natalie Truong, Evan Robinson, Korbin H Haycock, Allyson Hansen, Charlotte Derr, Phillip Andrus, Junaid Razzak, Joanna Palasz, Aarthi Kaviyarasu, Nathaniel A Sands, Benjamin S Abella,- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Objectives: To evaluate the clinical impact, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and intensive care units (ICU).
Methods: We established a prospective, multicenter, observational registry involving adult critically ill patients in whom focused TEE was performed for evaluation of out-of-hospital cardiac arrest (OHCA), in-hospital cardiac arrest (IHCA), evaluation of undifferentiated shock, hemodynamic monitoring, and/or procedural guidance in the ED, ICU, or operating room (OR) setting. The primary objective of the current investigation was to evaluate the clinical impact and safety of focused, point-of-care TEE in critically ill patients. Data elements included patient and procedure characteristics, laboratory values, timing of interventions, clinical outcomes, and TEE video images.
Results: A total of 771 cases were collected from 27 hospitals, including 506 (66%) intra and post arrest OHCA and IHCA, 221 (29%) initial evaluation of undifferentiated shock, 71 (9%) hemodynamic monitoring, and 93 (12%) procedural guidance. TEE changed management in 64% of cases of OHCA, in 71% of IHCA, and in 85% of patients with undifferentiated shock. There were no reported esophageal perforations or oropharyngeal injuries, and other procedural complications were rare.
Conclusion: A prospective, multicenter, and multidisciplinary TEE registry was successfully implemented, and demonstrated that focused TEE is safe and clinically impactful across multiple critical care applications. Further studies from this research network will accelerate the development of outcome-oriented research and knowledge translation on the use of TEE in emergency and critical care settings.