Use of transoesophageal echocardiography during the peri-operative period for trauma patients: sprinting before we can walk or run!

摘要

We read with interest the recent review article by Smyth et al [1], in which the authors outline the potentially enhanced clinical benefits of utilising transoesophageal echocardiography (TOE) in the peri-operative management of Role HE (enhanced) trauma patients. They cite the added advantages of TOE, over current clinical practice, in view of its ability to provide rapid, portable moving images of the heart and great vessels which would assist greatly in the haemodynamic assessment and management of trauma patients.Whilst we support the virtues of echocardiography in the management of trauma patients, however we personally strongly feel that transthoracic echocardiography (TTE) rather than TOE would be preferable for a number of important reasons. Compared with TOE, TTE is far easier and quicker to perform lending itself well to the multiple trauma scenario. TTE is completely non-invasive with images acquired simply by applying the echo probe to the skin of the chest wall or sub costal region and does not require oesophageal intubation and airway protection [2].