The Intensive Care Society and the Association of Anaesthetists are proud to announce the launch of the Accreditation in Focused Transoesophageal echocardiography (fTOE).
Aim of the Focused TOE echocardiography is to be used, in Intensive Care when unexplained life-threatening circulatory instability persists despite corrective therapy. fTOE should be considered whenever a transthoracic scan is unable or unlikely to answer the clinical question. This is frequently the case in the acute care setting when transthoracic windows are suboptimal.
A Focused TOE examination should be also considered, in non-cardiac surgery procedures, when patients are at increased risk of hemodynamic instability or ischemia.
The increased risk of cardiac instability is either due to the nature of surgery (significant blood loss/fluid shifts including but not limited to liver transplant, other major abdominal surgery, redo major joint replacement) or due to major surgery in the presence of significant comorbidity like valvular or ischemic heart disease. In this context fTOE can be used as an additional monitor and point-of-care tool for real-time answers.
The goals of a Focused TOE examination in a patient with hemodynamic instability include early diagnosis of the etiology of hypotension and guidance of therapeutic interventions to treat the underlying cause.