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Record W4415748144 · doi:10.1016/j.bpa.2025.10.004

Resuscitative transesophageal echocardiography

2025· article· en· W4415748144 on OpenAlexaff
Jacobo Moreno Garijo, Pablo Pérez d’Empaire

Bibliographic record

VenueBest practice & research. Clinical anaesthesiology · 2025
Typearticle
Languageen
FieldMedicine
TopicCardiac Arrest and Resuscitation
Canadian institutionsUniversity of TorontoSunnybrook Health Science Centre
Fundersnot available
KeywordsExtracorporeal membrane oxygenationResuscitationCardiogenic shockPulseless electrical activityIntravascular volume statusCredentialingPerioperativeCardiopulmonary resuscitation

Abstract

fetched live from OpenAlex

Resuscitative transesophageal echocardiography (rTEE) has emerged as a transformative point-of-care imaging modality that integrates diagnostic and procedural guidance into real-time resuscitation. Unlike transthoracic echocardiography (TTE), rTEE provides continuous, high-resolution cardiac imaging without interrupting chest compressions, overcoming traditional limitations in patients with undifferentiated shock or cardiac arrest. This review summarizes the evolution, technical foundations, and clinical applications of rTEE across resuscitation, extracorporeal membrane oxygenation (ECMO), and peri-arrest care. We discuss the development of focused scanning protocols—such as the ACEP 3-view, Resuscitative TEE 4-view, and 3 + 2 frameworks—that enable rapid qualitative assessment of cardiac activity, ventricular function, volume status, and reversible causes of arrest. Diagnostic advantages include superior rhythm classification (distinguishing pulseless electrical activity (PEA) , pseudo-PEA, fine VF, and standstill), improved pulse-check accuracy, and identification of the area of maximal compression (AMC) to optimize CPR quality. Procedurally, rTEE supports real-time ECMO cannulation, monitoring, and decannulation, complementing ELSO recommendations for both V-A and V–V configurations. Evidence-based echocardiographic parameters—such as LVOT velocity time integral (VTI), MAPSE, TAPSE, and t-IVT—inform readiness for ECMO liberation and predict recovery or need for durable mechanical support. Focused rTEE training pathways and credentialing frameworks are now available for anesthesiologists, intensivists, and emergency physicians, expanding its accessibility in perioperative and critical care environments. As the technology becomes more widespread, future research should standardize rTEE competency assessment, validate outcome-based protocols, and further integrate rTEE into precision-guided resuscitation algorithms.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.009
metaresearch head score (Gemma)0.016
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.595
Threshold uncertainty score0.992

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0090.016
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.002
Science and technology studies0.0000.002
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.093
GPT teacher head0.502
Teacher spread0.409 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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