Intensive Care Medicine

, Volume 39, Issue 4, pp 629–635

A pilot study on safety and clinical utility of a single-use 72-hour indwelling transesophageal echocardiography probe

  • Antoine Vieillard-Baron
  • Michel Slama
  • Paul Mayo
  • Cyril Charron
  • Jean-Bernard Amiel
  • Cédric Esterez
  • François Leleu
  • Xavier Repesse
  • Philippe Vignon
Original

DOI: 10.1007/s00134-012-2797-4

Cite this article as:
Vieillard-Baron, A., Slama, M., Mayo, P. et al. Intensive Care Med (2013) 39: 629. doi:10.1007/s00134-012-2797-4

Abstract

Purpose

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.

Conclusion

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.

Keywords

Transesophageal echocardiography Hemodynamic monitoring 

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2012

Authors and Affiliations

  • Antoine Vieillard-Baron
    • 1
    • 2
  • Michel Slama
    • 3
  • Paul Mayo
    • 4
  • Cyril Charron
    • 1
    • 2
  • Jean-Bernard Amiel
    • 5
    • 6
    • 7
  • Cédric Esterez
    • 1
    • 2
  • François Leleu
    • 3
  • Xavier Repesse
    • 1
    • 2
  • Philippe Vignon
    • 5
    • 6
    • 7
  1. 1.Intensive Care Unit, Section Thorax–Vascular Diseases–Abdomen–MetabolismUniversity Hospital Ambroise Paré, AP-HPBoulogneFrance
  2. 2.Faculté de Médecine Paris Ile de France OuestUniversité de Versailles Saint Quentin en YvelinesVersaillesFrance
  3. 3.Medical Intensive Care Unit, South HospitalUniversity Hospital of AmiensAmiensFrance
  4. 4.Medical Intensive Care UnitLong Island Jewish Medical Center and the Hofstra NSLIJ School of MedicineNew Hyde ParkUSA
  5. 5.Medical-surgical Intensive Care Unit, CHU de LimogesLimogesFrance
  6. 6.Center of Clinical Investigation, INSERM 0801LimogesFrance
  7. 7.University of LimogesLimogesFrance

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