"Hands-Free" continuous transthoracic monitoring of pericardiocentesis using a novel ultrasound transducer.
"Hands-Free" continuous transthoracic monitoring of pericardiocentesis using a novel ultrasound transducer.
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使用新型超声换能器对心包穿刺术进行“免提”连续经胸监测。
DOI：
10.1046/j.1540-8175.2003.03084.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Tzeng,John
中科院分区：
文献类型：
--
作者：
Chandraratna,PAN;Vijayasekaran,Sridhar;Brar,Prabhjoyt;Tzeng,John
背景心包穿刺术可以通过手持探头进行监测。本研究的目的是评估使用我们实验室(CONTISON)开发的一种新型超声换能器(CONTISON)监测心包穿刺术的可行性。2.5-MHz传感器的远端部分是球形的，安装在外部外壳中，允许360度转向。外部外壳使用粘合剂贴片固定在胸壁上。将CONTISON换能器放置在心尖，得到心尖四腔切面。心包穿刺术是从肋下位置进行的。对心包积液进行连续成像。记录心包穿刺术前后二尖瓣血流速度信号。第一次取液时，弃液50m L，然后经针注入搅拌盐水5m L。结果第一例患者的心包穿刺针位于左心室腔内。生理盐水注射可在左心室产生造影剂效应。逐渐抽出针头，直到心包囊内可见造影剂。共取出1100毫升，无进一步并发症。第二例患者有透明的液体，然后是带血的吸液。超声心动图显示心包内逐渐出现颗粒状回声，提示心包内凝块随后经手术排出。在剩下的7名患者中，搅拌的生理盐水在心包囊中产生了对比剂效果，表明针的位置正确。5例患者发现二尖瓣血流速度反常，4例患者经心包穿刺术后消失。无需调整探头。结论CONTISON探头可用于心包穿刺术的连续监测。这项技术可能会促进心包穿刺术。(《超声心动图》第20卷，2003年8月)
BackgroundPericardiocentesis can be monitored with a hand‐held transducer. The purpose of this study was to assess the feasibility of monitoring pericardiocentesis using a novel ultrasound transducer, which can be attached to the chest wall, developed in our laboratory (CONTISON).MethodsWe studied nine patients with large pericardial effusions. The 2.5‐MHz transducer is spherical in its distal part and mounted in an external housing to permit steering in 360 degrees. The external housing is attached to the chest wall using an adhesive patch. The CONTISON transducer was placed at the cardiac apex and an apical four‐chamber view obtained. Pericardiocentesis was performed from the subcostal position. The pericardial effusion was continuously imaged. Mitral inflow velocity signals were recorded before and after pericardiocentesis. When fluid was first obtained, 50 mL of fluid were discarded after which 5 mL of agitated saline was injected through the needle.ResultsIn the first patient the pericardiocentesis needle was seen in the left ventricular cavity. Saline injection produced a contrast effect in the left ventricle. The needle was gradually withdrawn until contrast was seen in the pericardial sac. A total of 1100 mL was removed without further complications. The second patient had clear fluid followed by blood stained aspirate. The echocardiogram revealed gradual appearance of granular echoes within the pericardial sac, suggestive of intrapericardial clot that was subsequently surgically evacuated. In the remaining seven patients, agitated saline produced a contrast effect in the pericardial sac indicative of proper needle position. Mitral flow velocity paradoxus was noted in five patients, and it resolved after pericardiocentesis in four patients. No adjustment of the transducer was required.ConclusionThe CONTISON transducer permitted continuous monitoring of pericardiocentesis. This technique could potentially facilitate pericardiocentesis. (ECHOCARDIOGRAPHY, Volume 20, August 2003)