(1666) Incidence and Findings of Lung Ultrasound in Focussed TEE: An Analysis of the rTEECoRe Registry

Tuesday, February 25, 2025

8:45am – 9:45am Eastern Time

Location: Connections Central - RST 07

First Author(s)

ZS

Zubair H. Siddiqui, MD

Aurora Health Care
Oak Creek , Wisconsin, USA

Co-Author(s)

PS

Pedro Salinas, MD

MD
Aurora St. Luke’s Medical Center, United States
DR

Dylan Rupska, MD

MD
Advocate Aurora Health, United States
KB

Katharine Burns, MD

MD
Advocate Aurora Health, United States
FT

Felipe Teran, MD

MD
Weill Cornell Medicine, United States
CO

Clark Owyang, MD

MD
Weill Cornell Medicine, United States
BA

Benjamin Abella, MD

MD
University of Penssylvania, United States
RP

Ross Prager, N/A

MD
Division of Critical Care Medicine, Western University, London, ON, Canada, United States
Vladyslav Dieiev, MD, MSc (he/him/his)

Aurora St. Luke's Medical Center
Milwaukee, Wisconsin, USA

Introduction: Focused transesophageal echocardiography (TEE) has emerged as valuable tool for the hemodynamic assessment of critically ill patients. Transesophageal lung ultrasound (TELUS), when integrated into TEE, offers additional diagnostic insights. However, data on its indications, findings, and clinical implications remain limited, primarily derived from single-institution studies. This study aimed to describe the utilization and findings of TELUS across institutions participating from the Resuscitative Transesophageal Echocardiography Collaborative Registry (rTEECoRe).

Methods: We reviewed data prospectively collected between January 2021 and July 2024 by 37 institutions from the rTEECoRe. Data included clinical information, operator characteristics, and TEE images. Studies explicitly labeled as TELUS were identified through database. These studies were reviewed to extract information on patient demographics, operator level, indications for TELUS, TELUS findings, and their implications for clinical management. Descriptive statistics were used for data interpretation.

Results: The analysis included 1,188 TEE studies from 37 institutions, of which 6.5% (77/1188) from 8 institutions reported performing TELUS as part of focused TEE studies. The majority of studies (75.3%, 58/77) were conducted by attending physicians with the remainder by fellows (24.7%, 19/77). The primary indication was shock (80.5%; 62/77), followed by hemodynamic monitoring (16.8%; 13/77) and cardiac arrest (2.5%; 2/77). TELUS findings were categorized as A-lines in 9.1% (7/77), B-lines in 67.5% (52/77), and pleural effusions in 37.7% (29/77). Changes in clinical management based on TEE findings were reported in 85.7% (66/77) of cases.

Conclusions: TELUS is a relatively infrequent component of focused TEE examinations performed in critically ill patients, performed predominantly by attending and fellow-level physicians to further characterize shock states and assist in hemodynamic monitoring. Further research is warranted to establish standardized imaging protocols and interpretation guidelines, thereby expanding the evidence base and utility of TELUS in emergency and critical care medicine.