Leichtle Stefan W, Singleton Andrew, Singh Mandeep, Griffee Matthew J, Tobin Joshua M
Department of Surgery, Division of Acute Care Surgery, Keck School of Medicine of the University of Southern California, 2051 Marengo Street, IPT, C5L100, Los Angeles, CA 90033, United States.
Department of Anesthesiology, Division of Trauma Anesthesiology, Keck School of Medicine of the University of Southern California, 1520 San Pablo Street, Suite 3451, Los Angeles, CA 90033-5315, United States.
J Crit Care. 2017 Aug;40:202-206. doi: 10.1016/j.jcrc.2017.04.007. Epub 2017 Apr 7.
The point-of-care ultrasound exam has become an essential tool for hemodynamic monitoring and resuscitation in the trauma bay as well as the intensive care unit. Transthoracic ultrasound provides a dynamic assessment of cardiac function, volume status, and fluid responsiveness that offers potential advantage over traditional methods of hemodynamic monitoring. More recently, a focused transthoracic echocardiography exam was described to improve immediate resuscitation of severely injured patients in the trauma bay. Transesophageal echocardiography (TEE) for trauma could expand upon the role of focused echocardiography. TEE offers improved visualization of cardiac anatomy and physiology, improved diagnostic accuracy, and real-time assessment of intraoperative resuscitation progress, particularly in the operating room. This review discusses the fundamental principles of echocardiography as well as different ultrasound modes with their respective strengths and limitations. It reviews the current literature on the use of TEE in trauma, and suggests views for a trauma resuscitation transesophageal echocardiography exam (TREE), including sample images and videos.
床旁超声检查已成为创伤急救室和重症监护病房进行血流动力学监测和复苏的重要工具。经胸超声可对心脏功能、容量状态和液体反应性进行动态评估，与传统血流动力学监测方法相比具有潜在优势。最近，有人描述了一种聚焦经胸超声心动图检查，以改善创伤急救室中重伤患者的即时复苏。用于创伤的经食管超声心动图（TEE）可扩展聚焦超声心动图的作用。TEE能更好地显示心脏解剖结构和生理功能，提高诊断准确性，并实时评估术中复苏进展，尤其是在手术室中。本文综述了超声心动图的基本原理以及不同超声模式的优缺点。回顾了目前关于TEE在创伤中应用的文献，并提出了创伤复苏经食管超声心动图检查（TREE）的观点，包括示例图像和视频。
