Critical Care Time 23. Resuscitative TEE with Dr. Ross Prager
May 6, 2024
Dr. Ross Prager, Resus-TEE expert, discusses the benefits of Resuscitative Transesophageal Echocardiography in critical care, covering its role in assessing heart conditions, cardiac arrest, shock, trauma, and procedural guidance. The chapter also explores the risks and logistics of implementing Resus-TEE, setting up a ResusTE program, and medical legal considerations for Point of Care Ultrasound.
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Phenotyping Shock with TEE
- The main benefit of TEE, and POCUS in general, lies in phenotyping shock (e.g., identifying RV failure or LV failure).
- Serial monitoring of patient improvement can then be done with other tools, like lactate or urine output.
TEE's Advantages Over Surface Echo
- TEE overcomes many limitations of surface echo, providing near-perfect views within seconds, especially during CPR or other procedures.
- It also improves physical real estate around the patient during resuscitation.
Indications for Resuscitative TEE
- Use resuscitative TEE in cases of undifferentiated shock, respiratory failure, cardiac arrest, trauma, and for procedural guidance (e.g., ECMO cannulation).
- Two prime indications are undifferentiated shock and cardiac arrest.