Dear All,
Not a case, just a question.
What do you use if you do a bubble study?
I think agitated saline is probably the most widely-used but probably carries a small risk of clinically significant air embolism if there is R > L shunting.
Anecdotally I’ve read about people using colloid-mixed-with-saline 50:50.
Then I found this:
http://ehjcimaging.oxfordjournals.org/content/8/3/s2
…which suggests that just the colloid (Haemaccel) will do the job.
Grateful to hear what anybody else does.
Roger
Dear All,
Not a case, just a question.
What do you use if you do a bubble study?
I think agitated saline is probably the most widely-used but probably carries a small risk of clinically significant air embolism if there is R > L shunting.
Anecdotally I’ve read about people using colloid-mixed-with-saline 50:50.
Then I found this:
http://ehjcimaging.oxfordjournals.org/content/8/3/s2
…which suggests that just the colloid (Haemaccel) will do the job.
Grateful to hear what anybody else does.
Roger
Comments
Honestly I just use saline
Honestly I just use saline and draw a cc of air agitate it and eliminate the syringe air before injecting the saline with bubbles mixed in it… but there are more elaborate ways of doing it and hetastarch instead of saline works nice as well.
We have th ewhole procedure described here as well with video in ionterventional procedures.
Welcome to the forum!
http://sonopath.com/resources/interventional-procedures
Honestly I just use saline
Honestly I just use saline and draw a cc of air agitate it and eliminate the syringe air before injecting the saline with bubbles mixed in it… but there are more elaborate ways of doing it and hetastarch instead of saline works nice as well.
We have th ewhole procedure described here as well with video in ionterventional procedures.
Welcome to the forum!
http://sonopath.com/resources/interventional-procedures
Hi!
I always use hetastarch,
Hi!
I always use hetastarch, not saline. Works better in my hands. fill a 5 ml syringe with hetastarch, connect it to an empty 3way stopcock that is attached to an empty 5 ml syringe. push the hetastarch forward and back between the syringes. Inject 2 ml per 10 kg into the vein. Gives a lot of bubbles
But keep in mind that the time from finishing making bubbles to the injection should be quite short!
Peter
Hi!
I always use hetastarch,
Hi!
I always use hetastarch, not saline. Works better in my hands. fill a 5 ml syringe with hetastarch, connect it to an empty 3way stopcock that is attached to an empty 5 ml syringe. push the hetastarch forward and back between the syringes. Inject 2 ml per 10 kg into the vein. Gives a lot of bubbles
But keep in mind that the time from finishing making bubbles to the injection should be quite short!
Peter
Thanks guys. It’s a great
Thanks guys. It’s a great forum when you can get an answer inside an hour. Maybe you could run the National Health Service for us in the UK!! It takes them a month to do anything.
I always used saline too but I was frightened by a cardiologist telling me that he’d killed a dog when he did a couple of shots of agitated saline. Altho I know it must be pretty rare.
The way I read that article (the link above) they used Haemaccel and didn’t even have to do the syringe-to-syringe thing. That sounded quite a nice, safe option. Maybe I’ll do a comparison of agitated v non-agitated next time.
Thanks guys. It’s a great
Thanks guys. It’s a great forum when you can get an answer inside an hour. Maybe you could run the National Health Service for us in the UK!! It takes them a month to do anything.
I always used saline too but I was frightened by a cardiologist telling me that he’d killed a dog when he did a couple of shots of agitated saline. Altho I know it must be pretty rare.
The way I read that article (the link above) they used Haemaccel and didn’t even have to do the syringe-to-syringe thing. That sounded quite a nice, safe option. Maybe I’ll do a comparison of agitated v non-agitated next time.
Ha ha well we certainly
Ha ha well we certainly respoind within 24 hours but most of us work online and we grab when we can.
I’ve done about 20+ bubbles studies wiht the agitated saline and always empty all the free air form the syringe. I can’t imagine those microbubbles can kill anything. When you want to do a bubble study the patient usually has bad disease and a little stress of any kind could kill them as well… so I wouldn’t blame the bubbles on that potentially. Lots of factors to consider.
Ha ha well we certainly
Ha ha well we certainly respoind within 24 hours but most of us work online and we grab when we can.
I’ve done about 20+ bubbles studies wiht the agitated saline and always empty all the free air form the syringe. I can’t imagine those microbubbles can kill anything. When you want to do a bubble study the patient usually has bad disease and a little stress of any kind could kill them as well… so I wouldn’t blame the bubbles on that potentially. Lots of factors to consider.