805-3 Diagnostic Value of Transesophageal Echocardiography During Cardiopulmonary Resuscitation

Abstract

Transesophageal echocardiography (TEE) permits the visualisation of the heart and great vessels without disturbing resuscitation attempts. Early information about the cause of the circulatory arrest can help in reestablishing spontaneous circulation. We investigated the diagnostic value of TEE during resuscitation. TEE was performed in adult patients with either in-hospital or out-of-hospital onset of a circulatory arrest, after endotracheal intubation. 30 patients were included, 17 with in-hospital arrest, and 13 with out-of-hospital arrest (initial rhythm: asystole 7, elektromechanical dissociation 7, bradycardia 11, ventricular fibrillation 3, sinus tachcycardia 2). Mean time between code call and start of TEE was 15 minutes, Return of spontaneous circulation (ROSC) was observed in 15 patients, 26 patients eventually died, 4 survived to discharge. The TEE diagnoses made were cardiac tamponade (CT) 6, myocardial infarction (MI) 10, pulmonary embolism (PE) 4, aortic aneurysm rupture (AAR) 3, papillary muscle rupture (PMR) 1, none 5. In 11 out of 12 post-mortem examinations and 1 out of 1 surgical procedure the TEE diagnosis was confirmed. CT MI PE AAR PMR none other TEE diagnosis 6 10 4 3 1 5 1 ROSC 2 7 1 3 1 0 1 Died 5 9 4 3 1 2 1 Diagnosis confirmed 3/3 7/7 1/1 0/1 0/0 3/3 0/0 TEE is helpful in establishing the cause of a circulatory arrest, thereby contributing to the early institution of specific therapeutic measures.