Hemodynamics derived from transesophageal echocardiography
- Elyse Foster, MD
Elyse Foster, MD
- Professor of Clinical Medicine
- University of California, San Francisco
Transesophageal echocardiography (TEE) can rapidly provide a comprehensive array of hemodynamic information. This is of particular importance in the critical care setting, where patients are often obtunded and mechanically ventilated; TEE may aid in differentiating among causes of hypotension, etiologies of dyspnea, and causes of chest pain. To reliably and safely apply TEE to critical care, skill, experience, and multidisciplinary approach are essential. A working relationship among intensivists, anesthesiologists, and cardiologists is an integral part of every successful critical care TEE program.
This topic will review the hemodynamic information which can be obtained during TEE. The general indications for TEE, along with its use in specific clinical situations, are discussed separately. (See "Transesophageal echocardiography: Indications, complications, and normal views" and "Transesophageal echocardiography in the evaluation of the left ventricle" and "Transesophageal echocardiography in the evaluation of mitral valve disease" and "Transesophageal echocardiography in the evaluation of aortic valve disease".)
Hemodynamic variables that are derived from TEE are comprehensive enough to provide accurate information ; variables that can be estimated include:
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- HEMODYNAMIC VARIABLES
- Cardiac output
- Left ventricular and atrial filling pressures
- - Doppler mitral inflow velocity
- - Pulmonary venous flow
- - Mitral regurgitation continuous-wave Doppler echocardiography
- Left ventricular and atrial chamber sizes (preload)
- - Hypovolemia
- - Hypervolemia
- - Intra-atrial septal motion