{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:46:56Z","timestamp":1791985616393,"version":"4.4.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Transesophageal echocardiography (TEE) is widely used in cardiac and non-cardiac surgeries for real-time cardiac monitoring. However, insertion of the TEE probe under general anesthesia can be challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Aim of the study was to compare the first pass success rate of two maneuvers for TEE probe insertion\u2014passive head lift versus combined chin lift\/jaw thrust. Secondary objectives included the number of attempts, time taken for insertion, hemodynamic response, and incidence of oral cavity or mucosal injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A prospective, observational study was conducted on 70 adult patients scheduled for elective cardiac surgery under general anesthesia. Eligible patients were assigned to one of two maneuvers: passive head lift (Group A) or combined chin lift\/jaw thrust (Group B). The TEE probe insertion was performed by an anesthesiologist experienced in TEE, with another observer recording number of attempts, insertion time, hemodynamic changes at specific time periods, and presence of oral injuries. Statistical analysis included the independent\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test, Wilcoxon-Mann-Whitney U test, Chi-squared test, and Fisher\u2019s Exact\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The first pass success rate was significantly higher in the passive head lift group (91.4%) compared to the chin lift\/jaw thrust group (60%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). The number of attempts and time taken for insertion were also significantly lower in Group A (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004 and P = 0.01, respectively). No significant differences in hemodynamic changes or mucosal injuries were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The passive head lift maneuver is superior to the combined chin lift\/jaw thrust maneuver for TEE probe insertion, with higher success on first attempt, shorter insertion time, and require only a single operator.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_89_26","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:00:19Z","timestamp":1791824419000},"page":"522-527","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Passive Head Lift and Combined Chin Lift\/Jaw Thrust Maneuvers for Transesophageal Echocardiograph (TEE) Probe Insertion"],"prefix":"10.4103","volume":"29","author":[{"given":"Akshaya","family":"Ananthanarayanan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Kumara","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"R1-20261014","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s001010050431","article-title":"TEE in An\u00e4sthesie und Intensivmedizin. Der diagnostische Stellenwert der trans\u00f6sophagealen Echokardiographie [Transesophageal echocardiography in anesthesia and intensive care. The diagnostic importance of transesophageal echocardiography]","volume":"46","author":"Loick","year":"1997","journal-title":"Anaesthesist"},{"key":"R2-20261014","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.redar.2020.06.001","article-title":"Intraoperative transesophageal echocardiography in cardiovascular surgery. Consensus document from the Spanish Society of Anesthesia and Critical Care (SEDAR) and the Spanish Society of Endovascular and Cardiovascular Surgery (SECCE)","volume":"67","author":"Garc\u00eda","year":"2020","journal-title":"Rev Esp Anestesiol Reanim (Engl Ed)"},{"key":"R3-20261014","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4103\/0971-9784.95080","article-title":"Transesophageal echocardiography: Instrumentation and system controls","volume":"15","author":"Prabhu","year":"2012","journal-title":"Ann Card Anaesth"},{"key":"R4-20261014","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s12630-017-1017-7","article-title":"Perioperative transesophageal echocardiography for non-cardiac surgery","volume":"65","author":"Fayad","year":"2018","journal-title":"Can J Anaesth"},{"key":"R5-20261014","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/EJA.0000000000000367","article-title":"McGRATH MAC video laryngoscope for insertion of a transoesophageal echocardiography probe: A randomised controlled trial","volume":"33","author":"Ishida","year":"2016","journal-title":"Eur J Anaesthesiol"},{"key":"R6-20261014","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/ALN.0b013e318190b56e","article-title":"Rigid laryngoscope-assisted insertion of transesophageal echocardiography probe reduces oropharyngeal mucosal injury in anesthetized patients","volume":"110","author":"Na","year":"2009","journal-title":"Anesthesiology"},{"key":"R7-20261014","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s12471-017-1036-6","article-title":"Feasibility of multiplane microtransesophageal echocardiographic guidance in structural heart disease transcatheter interventions in adults","volume":"25","author":"Nijenhuis","year":"2017","journal-title":"Neth Heart J"},{"key":"R8-20261014","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/aca.aca_287_20","article-title":"Factors predicting difficulty in insertion of real-time-three-dimensional transesophageal echocardiography probe in adult patients undergoing cardiac surgery","volume":"26","author":"Kiran","year":"2023","journal-title":"Ann Cardiac Anaesth"},{"key":"R9-20261014","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1053\/j.jvca.2015.02.003","article-title":"Effect of jaw thrust on transesophageal echocardiography probe insertion and concomitant oropharyngeal injury","volume":"29","author":"Chang","year":"2015","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R10-20261014","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1053\/j.jvca.2006.10.010","article-title":"Reverse Sellick's maneuver for transesophageal echocardiographic probe placement","volume":"21","author":"Sinha","year":"2007","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R11-20261014","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1053\/j.jvca.2025.11.033","article-title":"Use of video laryngoscope to reduce complications of transesophageal echocardiography probe insertion in children","volume":"40","author":"Gayathri","year":"2026","journal-title":"J Cardiothorac Vasc Anesth"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_89_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:01:49Z","timestamp":1791982909000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_89_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_89_26","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}