title: A pilot study on safety and clinical utility of a single-use 72-hour indwelling transesophageal echocardiography probe.
abstract: OBJECTIVE
  To evaluate the hemodynamic monitoring capability and safety of a single-use miniaturized transesophageal echocardiography (TEE) probe left in place in ventilated critically ill patients.
  
  
  METHODS
  The probe was inserted in 94 patients and designed to be left in place for up to 72 h. Three views were obtained: the superior vena caval transverse, the mid-esophageal four-chamber, and the transgastric mid-papillary short-axis views. Observational data on the feasibility of insertion, complications, image quality, and influence on management were recorded and analyzed.
  
  
  RESULTS
  No failure of probe insertion was observed. The nasogastric tube had to be removed in 17 % of cases. Image quality was judged as adequate or optimal in 91/94 (97 %) of cases in the superior vena caval view, 89/94 (95 %) of cases in the four-chamber view, and 86/94 (91 %) of cases in the short-axis view. The duration of monitoring was 32 ± 23 h, allowing 2.8 ± 1.6 hemodynamic evaluations per patient that led to a mean of 1.4 ± 1.5 therapeutic changes per patient. Among the 263 hemodynamic assessments, 132 (50 %) had a direct therapeutic impact in 62 patients (66 %). Two patients developed lip ulceration from the probe, and two patients had self-limited gastric bleeding.
  
  
  CONCLUSIONS
  The single-use miniaturized probe could be inserted in all patients. Image quality was acceptable in the majority of cases, and the information derived from the device was useful in making management decisions in patients with hemodynamic failure on ventilatory support. Further studies are needed to confirm the good tolerance and to compare the new device with other hemodynamic monitoring techniques.
authors.affiliation: Intensive Care Unit, Section Thorax-Vascular Diseases-Abdomen-Metabolism, University Hospital Ambroise Paré, AP-HP, 9 avenue Charles-de-Gaulle, 92104, Boulogne, France. antoine.vieillard-baron@apr.aphp.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Vieillard-Baron
authors.forename: Michel
authors.initials: M
authors.lastname: Slama
authors.forename: Paul
authors.initials: P
authors.lastname: Mayo
authors.forename: Cyril
authors.initials: C
authors.lastname: Charron
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Amiel
authors.forename: Cédric
authors.initials: C
authors.lastname: Esterez
authors.forename: François
authors.initials: F
authors.lastname: Leleu
authors.forename: Xavier
authors.initials: X
authors.lastname: Repesse
authors.forename: Philippe
authors.initials: P
authors.lastname: Vignon
mesh_terms: D055371:Acute Lung Injury / Q000000981:diagnostic imaging* / Q000628:therapy; D004209:Disposable Equipment; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005602:France; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D061214:Patient Safety; D010865:Pilot Projects; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy; D012769:Shock / Q000000981:diagnostic imaging* / Q000628:therapy; D013997:Time Factors