The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review

Abstract

We propose that transesophageal echocardiography (TEE) can be used to guide cardiac arrest resuscitation. We undertook a literature search (Medline and EMBase) to assess articles on that topic. Our search yielded 55 articles falling into 3 categories: TEE used in operating rooms, TEE used in emergency departments, and TEE used in other settings. In many cases, TEE changed the direction of the resuscitation; however, it is unclear whether TEE changed patient‐oriented outcomes, such as neurologically intact survival. Few adverse events related to TEE have been documented. There is growing evidence that physicians can learn to use TEE during resuscitations and apply the findings to clinical decisions.

Adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 Guidelines in Acute Point-of-Care Ultrasound Research

“…[1][2][3][7][8][9] The diagnostic accuracy of consultative ultrasound has been well studied for numerous applications [10][11][12][13][14] ; however, the test characteristics of POCUS remain an area of active research. 6,9,[15][16][17] Studies of diagnostic accuracy can be of heterogeneous methodological quality and have variable completeness of reporting. 18 Incomplete reporting can limit the ability to detect bias, determine generalizability of study results, and reproduce research.…”

Clot in Transit in a Patient with COVID-19: Transesophageal Echocardiographic Guidance of Mechanical Cardiopulmonary Resuscitation

“…TEE has been used as a modality to evaluate patients during resuscitation; imaging can effectively diagnose the cause of arrest, alter therapy, and guide chest compressions. 8,9 In a study of 33 patients with out-of-hospital cardiac arrest presenting to the emergency department, 12% of those presumed to be in asystole were found to have fine ventricular fibrillation by TEE. Importantly, the AMC was identified to be over the aortic root or LVOT in 53% of patients.…”

Transesophageal Echocardiography During Cardiopulmonary Resuscitation (CPR-TEE)

“…CPR-TEE was first reported in 1997, 8 and a prospective study, a literature review, and guidelines have been recently published. [10][11][12] Although the AHA guidelines recommend CPR procedures guided by a pulse check and rhythm analysis, 14 TEE is capable of identifying reversible causes cannulation was made without hesitation based on TEE findings. In case 4, TEE clarified the reason for difficult cannulation prior to PCPS and optimized the CPR procedure by stepwise confirmation, leading to a good outcome.…”