Discuss the use of trans-oesophageal echocardiography (TOE) in the ICU. Use the following headings in your answer: rationale for use, data obtained, and how it assists clinical management, associated risks, and limitations.
The act of helping the trainees structure their answer by offering specific headings is laudable, as without it this question could have easily turned into a trap for people who misunderstood the depth of what is expected (for example, from reading the first sentence, one would not immediately develop the impression that one needs to discuss the risks.
"Rationale for use" of TOE can probably be interpreted as "scenarios which call for the use of TOE instead of TTE", as that would make the greatest amount of sense. A "rationale for use" which includes all the various applications of cardiac sonography would not be a sensible way to answer. Thus:
How it assists clinical management
Cheitlin, Melvin D., et al. "ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography." A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). American College of Cardiology Foundation and American Heart Association (2003).
Roscoe, Andrew, and Tim Strang. "Echocardiography in intensive care."Continuing Education in Anaesthesia, Critical Care & Pain 8.2 (2008): 46-49.
Douglas, Pamela S., et al. "ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 Appropriateness Criteria for Transthoracic and Transesophageal Echocardiography⁎: A Report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American Society of Echocardiography, American College of Emergency Physicians, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society for ...." Journal of the American College of Cardiology 50.2 (2007): 187-204.
Mayo, Paul H., Mangala Narasimhan, and Seth Koenig. "Critical care transesophageal echocardiography." Chest 148.5 (2015): 1323-1332.