Transesophageal echocardiography in the critical care patient.

The superior resolution of TEE has substantially improved the diagnostic capabilities of the echocardiographer. In the critical care setting in which TTE is frequently extremely limited, TEE is proving to be an invaluable tool. The immediate availability of morphologic and hemodynamic information permits the cardiologist and intensivist to institute rapid changes in clinical management. Further miniaturization of transducers and probes as well as the ongoing development of automated techniques may eventually lead to the use of TEE as a monitoring device in the critical care patient. To date, there is no proof that application of this technique has improved overall survival in this group of patients. However, anecdotal experience and recently published series suggest that otherwise inapparent diagnoses have been made, leading to overall clinical improvement.