Feasibility and Operator-Reported Utility of Transesophageal Lung Ultrasound As an Adjunct to Resuscitative Transesophageal Echocardiography in the Evaluation of Shock: A Multicenter Observational Study
9 affiliations
- 1Department of Internal Medicine, Wake Forest University School of Medicine, Advocate Health, Winston-Salem, NC.
- 2Aurora Critical Care Services, Aurora St. Luke’s Medical Center, Advocate Health, Milwaukee, WI.
- 3Translational Resuscitation Sciences (TRS) Laboratory, Department of Emergency Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY.
- 4Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY.
- 5Department of Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, IL.
- 6Academic Affairs, Advocate Christ Medical Center, Advocate Health, Oak Lawn, IL.
- 7College of Medicine, California Northstate University, Elk Grove, CA.
- 8Lewis Katz School of Medicine at Temple University, St. Luke’s University Health Network, Bethlehem, PA.
- 9Department of Emergency Medicine, University of Illinois-Chicago, Chicago, IL.
Abstract
OBJECTIVES:: To describe the utilization, feasibility, and operator-reported diagnostic and management impact of transesophageal lung ultrasound (TELUS) integrated into resuscitative transesophageal echocardiography (TEE) for the assessment of mechanically ventilated adults with shock.
DESIGN:: Multicenter observational cohort study using prospectively collected data.
SETTING:: Twenty-three hospitals from the Resuscitative Transesophageal Echocardiography Collaborative Registry (rTEECoRe) network.
PATIENTS:: From 1213 registry TEE examinations, 379 met the inclusion criteria for shock evaluation or hemodynamic monitoring in mechanically ventilated adults; 96 (25.3%) of these included TELUS.
INTERVENTIONS:: None.
MEASUREMENTS AND MAIN RESULTS:: TELUS integration was associated with significantly higher operator-reported identification of shock etiology compared with resuscitative TEE alone (86.5% vs. 75.3%; odds ratio [OR], 1.95; 95% CI, 1.02–3.72; p = 0.04). Although overall clinical management changes were more frequently reported in the TELUS group, this difference did not reach statistical significance (78.1% vs. 71.7%; OR, 1.40; 95% CI, 0.82–2.41; p = 0.22). TELUS examinations were associated with longer procedure duration (median 21.5 vs.19.0 min; p = 0.01) and were predominantly performed by intensivists. Pulmonary findings, including B-lines, pleural effusions, consolidations, and A-line patterns, varied in frequency and were occasionally associated with specific respiratory or antimicrobial interventions. Procedure-related complications were rare and similar between groups.
CONCLUSIONS:: In this multicenter cohort of mechanically ventilated adults with shock, adding TELUS to resuscitative TEE was associated with a higher rate of operator-reported identification of shock etiology and was feasible with minimal additional procedure time. Prospective studies with standardized TELUS acquisition and interpretation, independent adjudication, and evaluation of patient-centered outcomes are needed to define clinical scenarios of incremental value.
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BibTeX
@article{dieiev2026feasibility,
title = {{Feasibility and Operator-Reported Utility of Transesophageal Lung Ultrasound As an Adjunct to Resuscitative Transesophageal Echocardiography in the Evaluation of Shock: A Multicenter Observational Study}},
author = {Vladyslav Dieiev and Pedro D. Salinas and Felipe Teran and Clark G. Owyang and Dylan Rupska and Aniruddh Kapoor and Zubair Siddiqui and Daniel Strama and Cindy Ndiaye and Nathaniel A. Sands and Aarthi Kaviyarasu and Katharine M. Burns and Nour Al Jalbout},
journal = {Critical Care Medicine},
year = {2026},
month = sep,
doi = {10.1097/ccm.0000000000007337},
url = {https://doi.org/10.1097/ccm.0000000000007337},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Feasibility and Operator-Reported Utility of Transesophageal Lung Ultrasound As an Adjunct to Resuscitative Transesophageal Echocardiography in the Evaluation of Shock: A Multicenter Observational Study
AU - Vladyslav Dieiev
AU - Pedro D. Salinas
AU - Felipe Teran
AU - Clark G. Owyang
AU - Dylan Rupska
AU - Aniruddh Kapoor
AU - Zubair Siddiqui
AU - Daniel Strama
AU - Cindy Ndiaye
AU - Nathaniel A. Sands
AU - Aarthi Kaviyarasu
AU - Katharine M. Burns
AU - Nour Al Jalbout
PY - 2026
DA - 2026/09/04
JO - Critical Care Medicine
DO - 10.1097/ccm.0000000000007337
UR - https://doi.org/10.1097/ccm.0000000000007337
AB - OBJECTIVES:: To describe the utilization, feasibility, and operator-reported diagnostic and management impact of transesophageal lung ultrasound (TELUS) integrated into resuscitative transesophageal echocardiography (TEE) for the assessment of mechanically ventilated adults with shock. DESIGN:: Multicenter observational cohort study using prospectively collected data. SETTING:: Twenty-three hospitals from the Resuscitative Transesophageal Echocardiography Collaborative Registry (rTEECoRe) network. PATIENTS:: From 1213 registry TEE examinations, 379 met the inclusion criteria for shock evaluation or hemodynamic monitoring in mechanically ventilated adults; 96 (25.3%) of these included TELUS. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: TELUS integration was associated with significantly higher operator-reported identification of shock etiology compared with resuscitative TEE alone (86.5% vs. 75.3%; odds ratio [OR], 1.95; 95% CI, 1.02–3.72; p = 0.04). Although overall clinical management changes were more frequently reported in the TELUS group, this difference did not reach statistical significance (78.1% vs. 71.7%; OR, 1.40; 95% CI, 0.82–2.41; p = 0.22). TELUS examinations were associated with longer procedure duration (median 21.5 vs.19.0 min; p = 0.01) and were predominantly performed by intensivists. Pulmonary findings, including B-lines, pleural effusions, consolidations, and A-line patterns, varied in frequency and were occasionally associated with specific respiratory or antimicrobial interventions. Procedure-related complications were rare and similar between groups. CONCLUSIONS:: In this multicenter cohort of mechanically ventilated adults with shock, adding TELUS to resuscitative TEE was associated with a higher rate of operator-reported identification of shock etiology and was feasible with minimal additional procedure time. Prospective studies with standardized TELUS acquisition and interpretation, independent adjudication, and evaluation of patient-centered outcomes are needed to define clinical scenarios of incremental value.
SN - 0090-3493
SN - 1530-0293
ER -