# Trends in Studies on Transesophageal Echocardiography in Emergency Medicine: A Scoping Review

## TL;DR

This study reviews the growing use of transesophageal echocardiography in emergency medicine, showing a sharp increase in research and applications since 2018.

## Contribution

The study provides a scoping review of publishing trends and applications of TEE in emergency medicine, highlighting recent rapid growth.

## Key findings

- TEE-related publications in emergency medicine increased from 1 in 1991 to 20 in 2023, with a significant rise since 2018.
- The most common TEE indications in emergency settings are cardiac arrest, shock, and procedural guidance.
- The U.S. leads in publishing EM TEE-related research, and the number of practitioners and institutions performing TEE has grown rapidly since 2018.

## Abstract

Transesophageal echocardiography (TEE) has been introduced in resuscitative scenarios in recent decades, with a growing number of emergency physicians learning, performing, and studying resuscitative TEE.

Our goal was to characterize publishing trends regarding TEE use in emergency medicine (EM) and to investigate the increasing interest in potential applications of TEE in emergency departments (ED).

We retrieved published research associated with the use of TEE in EM from the Web of Science database from inception to December 31, 2023. We analyzed trends based on the number of articles published annually. To systematically map trends related to TEE in emergency medicine (EM), we extracted data on the number of unique EM TEE practitioners, institutions performing EM TEE, study topics, and other characteristics from research articles and case reports. To better reflect research trends, we exclusively conducted subgroup analysis on the research articles. We used linear regression analysis to analyze trends and conducted checkpoints on the timelines.

Of the 964 titles and abstracts screened, we included 99 eligible published articles after careful review. Articles related to EM TEE increased from one article in 1991 to 20 articles in 2023, and the rate of publication has increased rapidly since 2018 (+12.4 publications per year, 95% confidence interval [CI] 9.8–15.0, P<0.001). The number of EM TEE practitioners and EM TEE-performing institutions underwent a rapid expansion with an inflection point between 2018–2020, with a rate of +91.7 practitioners per year and +36.5 institutions per year. Subgroup analysis revealed a similar trend in the published research articles. The most common indications for EM TEE were cardiac arrest (72.7%), shock (13.1%), and procedural guidance (11.1%). The United States published the majority of EM TEE-related articles (51.5%).

The present study highlights that TEE-related articles in EM continue to accelerate. Among the indications for TEE, cardiac arrest remains the most frequently discussed. This scoping review provides insights into the expanding interest and applications of TEE in the field of EM.