805-3 Diagnostic Value of Transesophageal Echocardiography During Cardiopulmonary Resuscitation

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.MethodsTEE was performed in adult patients with either in-hospital or out-of-hospital onset of a circulatory arrest, after endotracheal intubation.Results30 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.CTMIPEAARPMRnoneotherTEE diagnosis61043151ROSC2713101Died5943121Diagnosis confirmed3/37/71/10/10/03/30/0ConclusionTEE is helpful in establishing the cause of a circulatory arrest, thereby contributing to the early institution of specific therapeutic measures