In a recently published study the feasibility of hemodynamic monitoring and safety of hTEE was demonstrated in a group of ninety-four ventilated critically ill patients. In this study hTEE examinations were performed by four highly trained intensivist with extensive expertise in critically care echocardiography. The Department of Intensive Care Medicine Inselspital (KIM) has introduced hTEE in January 2012. The feasibility and quality of hemodynamic monitoring using hTEE by the department's intensivists was assessed in the context of a prospective quality review assessment. The study showed that the echocardiographic examinations using hTEE were of sufficient quality in a majority of examined ICU patients and that the inter-rater reliability between the intensivists and a trained cardiologist was substantial. However, as of yet studies assessing the impact of hemodynamic monitoring by hTEE on relevant patient outcomes are not available. Given the associated costs for the hTEE device and the ultrasound probes and the additional resource requirements for training and application, the efficacy and efficiency of hTEE monitoring in comparison to standard monitoring should be established.