hTEE on the
Evening News
A video segment aired in Erie PA, USA on Oct 10, 2012 spotlighting the positive impact of hTEE on the care of a Thomas Jefferson University Hospital patient following a heart attack. ABC, NBC and CBS affiliates throughout the country have since covered the story. Click here to view. |
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Featured Conferences
10th Doppler-Echocardiography in Intensive Care Medicine course at Erasme University Hospital November 6-8, 2012
Brussels, Belgium
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29th ACTA Autumn Meeting
November 8-9, 2012
Newcastle upon Tyne,
United Kingdom
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26th EAST Annual Scientific Assembly
January 15-19, 2013
Scottsdale, Arizona, USA
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 | Onofrio Patafio MD visualizing patient cardiac filling & function with the hTEE imaging system
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 | | Tia Boylan RDCS, right, demonstrating the tiny TEE probe to physicians at Anesthesiology 2012 |
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 | ImaCor drew crowds at ESICM as physicians came together to learn about hTEE in the critical care setting. Jenn Kujawski, center, of ImaCor discusses the hTEE Approach
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 | | CEO Peter Pellerito, center, discusses the ImaCor New Technology Assessment (NTA) with physician at the ESICM Annual Congress |
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Contact Us www.ImaCorInc.com  info@imacorinc.com 1-877-244-0657
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 Impact of hTEE on the Diagnosis and Management of a Hemodynamically Unstable Patient with Aneurysmal Subarachnoid Hemorrhage 
Joćo Joćo Mendes MD, Rui Pereira MD, Helena Teixeira MD, Isabel Marcćo MD, Ricardo Matos MD, Rui Moreno MD PhD
Sćo José Hospital, Lisbon, Portugal
(Excerpted, please click to read poster)
THE PATIENT
A 38-year-old woman presented to the Emergency Department soon after the onset of severe headache, emesis and loss of consciousness. She was an active smoker and has been a healthy woman with unknown medical conditions or medication, namely arterial hypertension.
INITIAL SYMPTOMS
...The emergency medical team found the patient in coma (Glasgow coma score 4) with bilateral ocular deviation to the right, without motor deficits. She was brought to the hospital and the brain CT scan showed subarachnoid hemorrhage with intraventricular bleeding (Fisher score IV) ...
hTEE EXAM 1
...An hTEE probe was placed and demonstrated severe LV wall motion abnormalities, borderline left ventricular performance and superior vena cava collapsibility (SVC) index of 38%...
hTEE EXAM 2 ON DAY 19 OF ICU STAY
...An hTEE was performed showing a dilated RV and paradoxical interventricular septum kinetic compatible with pulmonary
thromboembolism and effective treatment with heparin and fluids were started....
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Read More
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Differential Diagnosis of Shock and Multi-Stage Resuscitation of a Severely Burned Patient Guided by hTEE
Donald Reiff MD, University of Alabama Hospital at Birmingham, Birmingham, AL
(Excerpted, please click to read full case report) Management of complex burn and trauma cases can pose significant challenges for the intensivist: appropriate early resuscitation, in many cases resuscitation from an additional major surgery case, and in some cases, diagnosis and treatment of sepsis. We report here on the use of a miniaturized TEE probe (the ImaCor hTEE™ probe, designed and cleared by the FDA to remain indwelling up to 72 hours) to guide differential diagnosis of shock and multi-stage resuscitation of a patient with 74% total body surface area burns. Initial resuscitation followed the Brooke formula; subsequently the patient required resuscitation first for hypovolemic shock post-major surgery, and later for distributive shock associated with sepsis.
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TEE in Action: Video Excerpt from the
Medical Center of Central Georgia This video was presented in full at the American College of Surgeons (ACS) 2012 Annual Clinical Congress on Sept 30, 2012 to October 4, 2012. In this one-minute video excerpt, D. Benjamin Christie MD describes the case of a 71-year-old female, status post AAA repair with multiple co-morbidities...
For the full eight-minute MCCG video "Surgeon-Performed Ultrasound in the ICU: An Extension of the Physical Exam", please click on the link below.
   
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Report from CHEST 2012: Hitoshi Hirose MD Podium Presentation on the Use of hTEE in Weaning ECMO
Harold Hastings PhD, Co-founder and Chief Technology Officer (Excerpted, please click to read full article) In this column, I report on a podium presentation by Hitoshi ("Gene") Hirose MD of Thomas Jefferson University (TJU) Hospital at the recent CHEST meeting in Atlanta. Dr. Hirose's presentation on "ECMO for Bridge to Decision" addressed the challenge of "Intractable Cardiogenic Shock in the ICU: Transplant, Ventricular Assist Device, or Palliation?" (the title of the session in which he spoke).
Key points: - Extra-corporeal membrane oxygenation (ECMO) provides a useful bridge for many patients with intractable cardiogenic shock; some patients recover completely, others recover RV function but not LV function and can go home on implanted LVAD support, others receive a transplant, and finally, some with no chance at recovery or severe neurological events receive palliative care.
- Nobody goes home on ECMO; weaning is essential.
- The Thomas Jefferson SCCU team uses an hTEE-guided protocol for weaning ECMO. (emphasis mine)
- Finally, we note that the TJU SCCU team has used hTEE more generally in managing VAD as well as ECMO patients - their early experience is reported in Kang CY, Hirose H, Hastings H, Cavarocchi NC. Initial experience with Imacor hTEE-guided management of patients following transplant and mechanical circulatory support. ICU Director 2012;3:230-234. . .
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We were honored to have such a notable group of physicians speaking about hTEE at our inaugural European hTEE Symposium in Lisbon, Portugal on October 14th. Eleven physicians from Europe and the United States offered insightful studies on hTEE, pointing out that hTEE can advance their clinical objectives by accurately and directly visualizing the heart through three simple views from the bedside.
I would like to thank Jan Bakker MD, PhD, Maurizio Cecconi MD, Daniel De Backer MD, PhD, Nick Fletcher MD, Tobias Merz MD, Rui Moreno MD, PhD, Michael Pinsky MD, Dr hc, Jan Poelaert MD, PhD, Michel Slama MD, PhD, Antoine Vieillard-Baron MD, PhD, and Philippe Vignon MD, PhD who spoke at the symposium. It was a unique opportunity to learn more about their exceptional hTEE work - including the multicenter study from France and the results of Bern University Hospital's training study - as well as to discuss illustrative patient cases. Topics such as training and education took center stage during discussions. The simplicity of the device, as compared to conventional TEE or even TTE, was noted as a key factor for effectively managing patient hemodynamics.
I would also like to extend our appreciation to the teams from Erasme Hopital, Sao Jose Hospital and St. George's University Hospital who provided excellent case posters. We value everyone's input and recognize the contribution of this group of top-notch academicians and clinicians who made this an outstanding educational event. And finally, the night would not have been complete without exceptional facilitation of the discussion regarding training and education by Michael Pinsky MD Dr hc.
One of the most significant benefits of the Lisbon symposium is that it heralds a new era for ImaCor - we are now introducing symposia in the United States and elsewhere in the world to share study findings. Critical care thought-leaders are converging to discuss hemodynamic instability and how to manage it through hTEE.
Concomitantly, we continue to hone our cost savings story - hTEE tech assessments, a cost/benefit analysis on the hTEE technology, are now underway here and in Europe. We thank our customers, and will continue to support their goals of establishing patient selection indicators and protocols to best effect the 20% of their complex patients who utilize 80% of ICU resources.
With warm thanks,
Peter Pellerito
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