Safety, Feasibility and Clinical Utility of Critical Care Transesophageal Echocardiography in Hong Kong

NCT ID: NCT06178471

Last Updated: 2024-10-17

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 200 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-09-08
• Study Completion Date: 2027-07-01

Brief Summary

Critical care echocardiography is increasingly recognized as an essential skill for intensivists to achieve during their training and fellowship. It serves to provide critical information to guide clinical management in patients with hemodynamic collapse and respiratory insufficiency. While transthoracic echocardiography (TTE) could be adequate for assessment in most situations, patient factors such as body habitus, presence of chest drains and tubes, presence of thoracic surgical dressings, requirement of high ventilatory support may impede operators from obtaining satisfactory images for evaluation. Moreover, operators in TTE require time and experience for adequate skill and technique acquisition. In specific pathologies such as infective endocarditis, presence of thrombus in left atrial appendage, and evaluation of intracardiac shunts, TEE has been shown to be superior to TTE for proper and accurate diagnosis. Therefore, TEE is widely accepted as the preferred and essential modality for echocardiographic examination especially in European countries. Countries such as France and North American have included critical care TEE as a core curriculum in the critical care training pathway.

In Hong Kong, only basic critical care echocardiography using TTE is required during training and in clinical practice. TEE evaluation is mostly performed in cardiac surgery units by cardiac anesthetists and in stable patients by cardiologists. Critical care TEE is seldom performed by intensivists independently for hemodynamic assessment and evaluation of cardiopulmonary failure. This study describes the safety, feasibility, and clinical utility of critical care TEE by critical care fellows in a university-affiliated institute providing tertiary care to the territory. With implementation of this essential technique in a single center, this study serves to act as a generalizable guidance to achieve an ultimate goal of incorporating this technique as core curriculum in critical care training in parts of the world where critical care TEE is not well established.

Conditions

Cardiopulmonary Failure

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: CROSS_SECTIONAL

Interventions

Transesophageal Echocardiography

The use of transesophageal echocardiography to diagnose cardiopulmonary failure in ICU patients with suboptimal or inadequate transthoracic echocardiography examinations.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• Age ≧ 18; AND
• Admitted to the mixed medical-surgical intensive care units of Queen Mary Hospital in Hong Kong; AND
• Intubated for invasive mechanical ventilation; AND
• Clinically indicated for transesophageal echocardiography (TEE)

Exclusion Criteria

Patient possessing absolute contraindication(s) to TEE examination according to the ASE guideline 2013:

• Perforated viscus
• Esophageal stricture
• Esophageal tumor
• Esophageal perforation
• Esophageal laceration
• Esophageal diverticulum
• Active upper gastrointestinal bleed

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Queen Mary Hospital, Hong Kong

OTHER

Sponsor Role: lead

Responsible Party

Wincy Wing-Sze Ng

Associate Consultant, Adult Intensive Care Unit

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Wincy Ng, MRCP

Role: CONTACT

wincyngwingsze@gmail.com

64806646

Other Identifiers

20231212-006-000

Identifier Type: -

Identifier Source: org_study_id