Handheld vs. conventional transesophageal echocardiography in non-cardiac surgical intensive care unit patients.
OBJECTIVE
We examined the feasibility of a newly developed handheld ultrasound device capable of transesophageal echocardiography (TEE).


METHODS
Prospective case series in a non-cardiac surgical intensive care unit including 18 deeply sedated and endotracheally intubated critically ill non-cardiac surgical patients. The imaging quality and findings of a newly developed handheld device were compared to those of a cart-based standard TEE system. All patients were examined with both systems in a randomized order by independent examiners performing a structured and complete TEE examination. The imaging quality of the standard cardiac cross sections and spectral Doppler studies of the cardiac valves was assessed on an analog scale from 1 (excellent) to 5 (insufficient). The time requirements for each study were documented.


RESULTS
We did not detect significant differences in two-dimensional imaging. Continuous-wave Doppler imaging of the left ventricular outflow tract and pulsed-wave Doppler imaging of the transmitral flow were significantly better (p <0.001) with the standard system.


CONCLUSIONS
Handheld TEE is a goal-oriented diagnostic tool, which may sufficiently replace a standard cart-based TEE system in unstable critically ill patients when an acute gross diagnosis is required.
Schneider
C
C
Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Germany.
Schwemmer
U
U
Kredel
M
M
Frommer
M
M
Wurmb
T
T
Greim
C
C
Roewer
N
N
Brederlau
J
J
D016638:Critical Illness; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007362:Intensive Care Units; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative; D018615:Ultrasonography, Doppler, Color; D016277:Ventricular Function, Left