9 Transoesophageal echocardiography in trauma patients

Transoesophageal echocardiography (TOE) is an outstanding tool for the clinical management of trauma patients. It provides valuable information on haemodynamic instability, diagnosis of myocardial contusion, traumatic valve dysfunction, traumatic aortic injuries, intrathoracic bleeding and systemic gas embolism related to pulmonary contusion. The accuracy of TOE in the diagnosis of traumatic aortic injuries is not perfectly determined: the main limitation is the operator dependency. Experience of trauma patients and specific signs of cardiovascular injuries are the keys to the extensive use of TOE in trauma centres. The main interest in TOE is the capability to perform TOE promptly upon admission, in the intensive care unit and in the operative room. In the case of delayed surgery of aortic injuries, TOE examination can participate in the decision-making process.