Critical Care Time 23. Resuscitative TEE with Dr. Ross Prager
May 6, 2024
Dr. Ross Prager, Resus-TEE expert, discusses the benefits of Resuscitative Transesophageal Echocardiography in critical care, covering its role in assessing heart conditions, cardiac arrest, shock, trauma, and procedural guidance. The chapter also explores the risks and logistics of implementing Resus-TEE, setting up a ResusTE program, and medical legal considerations for Point of Care Ultrasound.
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TEE's Advantages Over Surface Echo
- TEE overcomes many limitations of surface echo, providing near-perfect views within seconds, especially during CPR or other procedures.
- It also improves physical real estate around the patient during resuscitation.
Indications for Resuscitative TEE
- Use resuscitative TEE in cases of undifferentiated shock, respiratory failure, cardiac arrest, trauma, and for procedural guidance (e.g., ECMO cannulation).
- Two prime indications are undifferentiated shock and cardiac arrest.
CPR Repositioning with TEE Guidance
- Dr. Prager recounts a cardiac arrest case with low end-tidal CO2 despite seemingly good compressions.
- TEE revealed no aortic valve opening; repositioning CPR drastically improved end-tidal CO2 and led to ROSC.