title: Transesophageal echocardiography in the management of burn patients.
abstract: A systematic review was conducted to assess the level of evidence for the use of transesophageal echocardiography (TEE) in the management of burn patients. We searched any article published before and including June 30, 2013. Our search yielded 118 total publications, 11 met the inclusion criteria of burn injury and TEE. Available studies published in any language were rated and included. At the present time, there are no available systematic reviews/meta-analyses published that met our search criteria. Only a small number of clinical trials, all with a limited number of patients were available. Therefore, a meta-analysis on outcome parameters was not performed. However, the major pathologic findings in burn patients were reduced left ventricular (LV) systolic and diastolic function, mitral valve vegetation, pulmonary hypertension, pericardial effusion, fluid overload, and right heart failure. The advantages of TEE include offering direct assessment of cardiac valve competency, myocardial contractility, and most importantly real time assessment of adequacy of hemodynamic resuscitation and preload in the acute phase of resuscitation, with minimal additional risk. TEE serves multiple diagnostic purposes and is being used to better understand the fluid status and cardiac physiology of the critically ill burn patient. Randomized controlled trials especially on fluid resuscitation and cardiac performance in acute burns are warranted to potentially further improve outcome.
authors.affiliation: Department of Anesthesiology, University of Texas Medical Branch and Shriners Burns Hospital for Children at Galveston, USA; Critical Care Research Group, University of Queensland and the Prince Charles Hospital, Brisbane, Australia; Department of Cardiothoracic Anaesthesia and Intensive Care, Oxford Heart Centre, Oxford University Hospitals, Oxford, UK; Klinik für Anästhesie und Intensivtherapie, Philipps Universität Marburg, Germany. Electronic address: momaybau@utmb.edu.
authors.forename: Marc O
authors.initials: MO
authors.lastname: Maybauer
authors.affiliation: Department of Anesthesiology, University of Texas Medical Branch and Shriners Burns Hospital for Children at Galveston, USA.
authors.forename: Sven
authors.initials: S
authors.lastname: Asmussen
authors.affiliation: Critical Care Research Group, University of Queensland and the Prince Charles Hospital, Brisbane, Australia; Department of Cardiology, University of Queensland and the Prince Charles Hospital, Brisbane, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Platts
authors.affiliation: Critical Care Research Group, University of Queensland and the Prince Charles Hospital, Brisbane, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
authors.affiliation: Department of Cardiothoracic Anaesthesia and Intensive Care, Oxford Heart Centre, Oxford University Hospitals, Oxford, UK.
authors.forename: Filippo
authors.initials: F
authors.lastname: Sanfilippo
authors.affiliation: Klinik für Anästhesie und Intensivtherapie, Philipps Universität Marburg, Germany.
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Maybauer
mesh_terms: D002056:Burns / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D019468:Disease Management; D017548:Echocardiography, Transesophageal; D005440:Fluid Therapy / Q000009:adverse effects; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000209:etiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology; D014883:Water-Electrolyte Imbalance / Q000000981:diagnostic imaging / Q000209:etiology
keywords: Burn injury; Diastolic; Resuscitation; Shock; Systolic; TEE; TOE