Use of a Video Laryngoscope to Reduce Complications of Transesophageal Echocardiography Probe Insertion: A Multicenter Randomized Study

Borde, Deepak; Kumar, C.; Jasapara, Amish; Shetty, Vijay; Juvekar, Nilesh; Desurkar, Vinayak; Gaidu, Jyoti; Joshi, Pooja; Asegaonkar, Balaji; Unnikrihnan, KP; Vipinraj, V.; Joshi, Shreedhar; Koshy, Thomas

doi:10.1053/j.jvca.2022.07.017

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…The use of video laryngoscopy during TEE probe insertion may improve the success of first-pass insertion attempts and decrease the rate of oropharyngeal injuries associated with probe insertion. 55 Because of the improved visualization TEE often provides and the variation in training and purpose of TEE across specialties, missed diagnoses may be a concern for institutions wishing to implement TEE as part of cardiac resuscitation. It is important that in the CA and postarrest setting, the list of diagnoses and procedural aids for which TEE is used should be tightly constrained; and any potential findings outside of those should not be addressed.…”

Section: Risks Of Tee In the Ca Settingmentioning

confidence: 99%

“…This higher complication rate is likely due to a combination of patient acuity, the emergent nature of the procedure, and the initiation of ECMO with anticoagulation. The use of video laryngoscopy during TEE probe insertion may improve the success of first-pass insertion attempts and decrease the rate of oropharyngeal injuries associated with probe insertion 55 …”

Section: Risks Of Tee In the Ca Settingmentioning

confidence: 99%

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Seeing the heart of the problem: transesophageal echocardiography in cardiac arrest: a practical review

Wray,

Gerstein,

Ball

et al. 2023

International Anesthesiology Clinics

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Section: Risks Of Tee In the Ca Settingmentioning

confidence: 99%

Section: Risks Of Tee In the Ca Settingmentioning

confidence: 99%

Seeing the heart of the problem: transesophageal echocardiography in cardiac arrest: a practical review

Wray,

Gerstein,

Ball

et al. 2023

International Anesthesiology Clinics

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Section: Risks Of Toe and How To Minimize Themmentioning

confidence: 99%

“…Video laryngoscope allows excellent visualization of the structures posterior to the laryngeal inlet, thereby enhancing the success rate of probe insertion and reducing the incidence of injury to surrounding structures. 16 It is also important that the operator does not become task fixated on what is a complex procedure, from a technical and cognitive perspective and lose sight of the potentially unstable patient.…”

Section: Risks Of Toe and How To Minimize Themmentioning

confidence: 99%

Focused transoesophageal TOE (fTOE): A new accreditation pathway

Rubino

Peck

Miller

et al. 2023

Journal of the Intensive Care Society

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The concept of a focused ultrasound study to identify sources of haemodynamic instability has revolutionized patient care. Point-of-care ultrasound (POCUS) using transthoracic scanning protocols, such as FUSIC Heart, has empowered non-cardiologists to rapidly identify and treat the major causes of haemodynamic instability. There are, however, circumstances when a transoesphageal, rather than transthoracic approach, may be preferrable. Due to the close anatomical proximity between the oesophagus, stomach and heart, a transoesphageal echocardiogram (TOE) can potentially overcome many of the limitations encountered in patients with poor transthoracic ultrasound windows. These are typically patients with severe obesity, chest wall injuries, inability to lie in the left lateral decubitus position and those receiving high levels of positive airway pressure. In 2022, to provide all acute care practitioners with the opportunity to acquire competency in focused TOE, the Intensive Care Society (ICS) and Association of Anaesthetists (AA) launched a new accreditation pathway, known as Focused Transoesophageal Echo (fTOE). The aim of fTOE is to provide the practitioner with the necessary information to identify the aetiology of haemodynamic instability. Focused TOE can be taught in a shorter period of time than comprehensive and teaching programmes are achievable with support from cardiothoracic anaesthetists, intensivists and cardiologists. Registration for fTOE accreditation requires registration via the ICS website. Learning material include theoretical modules, clinical cases and multiple-choice questions. Fifty fTOE examinations are required for the logbook, and these must cover a range of pathology, including ventricular dysfunction, pericardial effusion, tamponade, pleural effusion and low preload. The final practical assessment may be undertaken when the supervisors deem the candidate’s knowledge and skills consistent with that required for independent practice. After the practitioner has been accredited in fTOE, they must maintain knowledge and competence through relevant continuing medical education. Accreditation in fTOE represents a joint venture between the ICS and AA and is endorsed by Association of Cardiothoracic Anaesthesia and Critical care (ACTACC). The process is led by TOE experts, and represents a valuable expansion in the armamentarium of acute care practitioners to assess haemodynamically unstable patients.

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“…Recent reviews highlighted the low (typically < 1%), but important risk of gastrointestinal and oropharyngeal injury that can result from placement and manipulation of the TEE probe and providers are encouraged to assess for preexisting oropharyngeal or esophageal abnormalities that can predispose patients to complications [26 ▪▪ ,27 ▪ ]. As a recent multicenter randomized controlled trial showed, video laryngoscope assisted probe insertion can reduce both the number of placement attempts and subsequent likelihood of oropharyngeal injury [28 ▪ ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative hemodynamic monitoring in cardiac surgery

Grant,

Salenger,

Lobdell

2023

Current Opinion in Anaesthesiology

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Purpose of review Cardiac surgery has traditionally relied upon invasive hemodynamic monitoring, including regular use of pulmonary artery catheters. More recently, there has been advancement in our understanding as well as broader adoption of less invasive alternatives. This review serves as an outline of the key perioperative hemodynamic monitoring options for cardiac surgery. Recent findings Recent study has revealed that the use of invasive monitoring such as pulmonary artery catheters or transesophageal echocardiography in low-risk patients undergoing low-risk cardiac surgery is of questionable benefit. Lesser invasive approaches such a pulse contour analysis or ultrasound may provide a useful alternative to assess patient hemodynamics and guide resuscitation therapy. A number of recent studies have been published to support broader indication for these evolving technologies. Summary More selective use of indwelling catheters for cardiac surgery has coincided with greater application of less invasive alternatives. Understanding the advantages and limitations of each tool allows the bedside clinician to identify which hemodynamic monitoring modality is most suitable for which patient.

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Use of a Video Laryngoscope to Reduce Complications of Transesophageal Echocardiography Probe Insertion: A Multicenter Randomized Study

Cited by 10 publications

References 19 publications

Seeing the heart of the problem: transesophageal echocardiography in cardiac arrest: a practical review

Seeing the heart of the problem: transesophageal echocardiography in cardiac arrest: a practical review

Focused transoesophageal TOE (fTOE): A new accreditation pathway

Perioperative hemodynamic monitoring in cardiac surgery

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