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J Crit Care. 2017 Aug;40:202-206. doi: 10.1016/j.jcrc.2017.04.007. Epub 2017 Apr 7.

Transesophageal echocardiography in the evaluation of the trauma patient: A trauma resuscitation transesophageal echocardiography exam.

Author information

1
Department of Surgery, Division of Acute Care Surgery, Keck School of Medicine of the University of Southern California, 2051 Marengo Street, IPT, C5L100, Los Angeles, CA 90033, United States.
2
Department of Anesthesiology, Division of Trauma Anesthesiology, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 3451, Los Angeles, CA 90033-5315, United States.
3
Department of Anesthesiology, University of Utah School of Medicine, 30 N 1900 E Room 3C444, Salt Lake City, UT 84132-2501, United States.
4
Department of Anesthesiology, Division of Trauma Anesthesiology, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 3451, Los Angeles, CA 90033-5315, United States. Electronic address: Joshua.Tobin@med.usc.edu.

Abstract

The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay. Transesophageal echocardiography (TEE) for trauma could expand upon the role of focused echocardiography. TEE offers improved visualization of cardiac anatomy and physiology, improved diagnostic accuracy, and real-time assessment of intraoperative resuscitation progress, particularly in the operating room. This review discusses the fundamental principles of echocardiography as well as different ultrasound modes with their respective strengths and limitations. It reviews the current literature on the use of TEE in trauma, and suggests views for a trauma resuscitation transesophageal echocardiography exam (TREE), including sample images and videos.

KEYWORDS:

Resuscitation; Transesophageal echocardiography; Trauma

PMID:
28433951
DOI:
10.1016/j.jcrc.2017.04.007
[Indexed for MEDLINE]

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