“…Inserting the probe beyond the bicaval view is helpful for assessing the IVC, the liver, and the hepatic veins. Furthermore, the literature contains many reports of TEE imaging of the pleura, the kidneys, and even the spinal cord [7–10]. Fig.…”
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction. However, intraoperative transesophageal echocardiography can be used to "visualize" other organs too; thanks to its proximity and access to multiple acoustic windows: liver, lung, spleen, and kidney. Although only limited scientific evidence exists promoting this comprehensive use, we describe the feasibility of TEE in the setting of liver transplantation: it is a highly valuable tool, not only as a cardiovascular monitoring, but also as a tool to evaluate lungs and pleural spaces, to assess hepatic vein blood flow and inferior vena cava anastomosis and patency, i.e., in cases of modified surgical techniques. The aim of this case series is to add our own experience of TEE as a comprehensive intraoperative monitoring tool in the field of orthotopic liver transplantation (and major liver resection) to the literature.
“…Inserting the probe beyond the bicaval view is helpful for assessing the IVC, the liver, and the hepatic veins. Furthermore, the literature contains many reports of TEE imaging of the pleura, the kidneys, and even the spinal cord [7–10]. Fig.…”
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction. However, intraoperative transesophageal echocardiography can be used to "visualize" other organs too; thanks to its proximity and access to multiple acoustic windows: liver, lung, spleen, and kidney. Although only limited scientific evidence exists promoting this comprehensive use, we describe the feasibility of TEE in the setting of liver transplantation: it is a highly valuable tool, not only as a cardiovascular monitoring, but also as a tool to evaluate lungs and pleural spaces, to assess hepatic vein blood flow and inferior vena cava anastomosis and patency, i.e., in cases of modified surgical techniques. The aim of this case series is to add our own experience of TEE as a comprehensive intraoperative monitoring tool in the field of orthotopic liver transplantation (and major liver resection) to the literature.
“…26 In our experience, left-sided B-lines are present on the preprocedure TELU exam in a significant proportion of cardiac surgery cases. While others have also reported the presence of this artefact using TEE, 15 the exact meaning of The volume of the effusion can be estimated from its maximal surface area (CSA max ) in the transverse plane (0°electronic plane)…”
Section: Alveolar-interstitial Syndromementioning
confidence: 99%
“…Few reports have been published addressing the specific aspects of transesophageal lung ultrasonography (TELU). [3][4][5][6][7][8][9][10][11][12][13][14][15] The aim of this narrative review is to provide a comprehensive description of the TELU technique by summarizing the existing literature on the subject and describing our own experience that extrapolates from the transthoracic lung ultrasonography literature. In order to identify pertinent literature published on TELU, we searched PubMed, Google Scholar, and EMBASE TM to find relevant articles using multiple research strategies, including a combination of [''ultrasonography'' or ''transesophageal echocardiography''] and [''lung'', ''lung diseases'', ''pleural effusion'', ''pneumonia'', ''pneumothorax'', ''consolidation'', or ''atelectasis''] or specific lung ultrasonography terminology such as ''Blines'', ''Lung Rockets'', ''Lung Sliding''.…”
Background Acute deterioration in respiratory status commonly occurs in patients who cannot be transported for imaging studies, particularly during surgical procedures and in critical care settings. Transthoracic lung ultrasonography has been developed to allow rapid diagnosis of respiratory conditions at the bedside. Nevertheless, the thorax is not always accessible, especially in the perioperative setting. Transesophageal lung ultrasonography (TELU) can be used to circumvent this problem. Purpose The aim of this narrative review is to provide a complete description of the TELU technique by summarizing the existing literature on the subject and describing our own experience that extrapolates from transthoracic lung ultrasonography. Principal findings The use of TELU can provide point-ofcare real-time information for quickly establishing the etiology of acute hypoxemia. The transesophageal probe is placed in close proximity to the posterior regions of the lungs where lung consolidation and pleural effusions are most often seen; however, most of the artefacts relied on by transthoracic ultrasound have yet to be validated with TELU. Moreover, the relative invasiveness of TELU compared with transthoracic ultrasonography may limit its use to specific situations when the probe is already in place, as during cardiac anesthesia or when the anterior thorax is inaccessible. The main advantage of TELU may lie in the ability to integrate both cardiac and pulmonary assessments in one single examination. Conclusion Anesthesiologists and intensivists who already use transesophageal echocardiography on a regular basis should consider adding TELU to their clinical assessment of hypoxemia and related pulmonary pathologies. Nevertheless, the literature specifically supporting TELU is relatively limited, and further validation studies are needed.
RésuméContexte Des détériorations aiguës de l'état respiratoire de patients qui ne peuvent être transportés pour des examens d'imagerie sont fréquentes, particulièrement lors d'interventions chirurgicales ainsi que dans le contexte des soins intensifs. L'échographie pulmonaire transthoracique a été mise au point afin de permettre de diagnostiquer rapidement la cause d'une détérioration respiratoire au chevet du patient. Or, le thorax n'est pas toujours accessible, particulièrement dans un contexte périopératoire.L'échographie transoesophagienne pulmonaire (ETOP) peut alors être utilisée pour pallier ce problème.
“…6 En outre, la littérature comporte plusieurs comptes rendus d'ETO des plèvres, des reins, et même de la moelle épinière. [7][8][9] Dans ce numéro du Journal, Cavayas et coll. nous présentent une revue détaillée de l'échographie transoesophagienne pulmonaire (ETOP).…”
unclassified
“…6 Furthermore, the literature contains many reports of TEE imaging of the pleuras, kidneys, and even the spinal cord. [7][8][9] In this issue of the Journal, Cavayas et al present a detailed review of transesophageal lung ultrasound (TELU). 10 The manuscript is divided into three parts.…”
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