The usefulness of a 10% air-10% blood-80% saline mixture for contrast echocardiography: Doppler measurement of pulmonary artery systolic pressure

Doo Soo Jeon, Huai Luo, Takahiro Iwami, Takashi Miyamoto, Andrea V. Brasch, James Mirocha, Tasneem Zehra Naqvi, Robert J. Siegel

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVES: We assessed an air-blood-saline mixture for Doppler measurement of pulmonary artery systolic pressure (PASP) and the mechanism of enhancement of the Doppler signal by this mixture. BACKGROUND: Underestimation of PASP by Doppler echocardiography occurs with inadequate continuous wave (CW) signals of tricuspid regurgitation (TR). METHODS: We assessed in vitro the diameter and concentration of microbubbles of agitated air-saline mixture, air-blood-saline mixture and 10% air-10% plasma-80% saline mixture immediately, 5, 10 and 20 s after agitation. In 20 patients, PASP was estimated by Swan-Ganz catheter and CW Doppler of TR: 1) without contrast injection; 2) with intravenous injection of 10% air-90% saline; and 3) 10% blood-10% air-80% saline mixture. RESULTS: Compared to air-saline, addition of blood or plasma to the air-saline solution significantly increased the concentration of microbubbles (p < 0.001). The air-blood-saline (26.7 ± 7.2 μ) and air-plasma-saline mixture (25.3 ± 7.4 μ) had smaller microbubbles than air-saline mixture (31.6 ± 8.2 μ) (p < 0.001). The correlation between Doppler- and catheter-measured PASP at baseline (r = 0.64) improved with agitated air-saline (r = 0.86). With the air-blood-saline mixture, the correlation further improved (r = 0.92) and the best limits of agreement were obtained. CONCLUSIONS: The combination of the patient's own blood is a method of making a sterile solution of numerous small microbubbles for injection into the right-sided cardiac chambers. Clinically, the air-blood-saline mixture is easily prepared at bedside and is superior to the air-saline mixture in assessing PASP in patients with inadequate CW Doppler signals.

Original languageEnglish (US)
Pages (from-to)124-129
Number of pages6
JournalJournal of the American College of Cardiology
Volume39
Issue number1
DOIs
StatePublished - Jan 2 2002
Externally publishedYes

Fingerprint

Pulmonary Artery
Echocardiography
Air
Blood Pressure
Microbubbles
Tricuspid Valve Insufficiency
Catheters
Injections
Doppler Echocardiography
Sodium Chloride
Intravenous Injections

ASJC Scopus subject areas

  • Nursing(all)

Cite this

The usefulness of a 10% air-10% blood-80% saline mixture for contrast echocardiography : Doppler measurement of pulmonary artery systolic pressure. / Jeon, Doo Soo; Luo, Huai; Iwami, Takahiro; Miyamoto, Takashi; Brasch, Andrea V.; Mirocha, James; Naqvi, Tasneem Zehra; Siegel, Robert J.

In: Journal of the American College of Cardiology, Vol. 39, No. 1, 02.01.2002, p. 124-129.

Research output: Contribution to journalArticle

Jeon, Doo Soo ; Luo, Huai ; Iwami, Takahiro ; Miyamoto, Takashi ; Brasch, Andrea V. ; Mirocha, James ; Naqvi, Tasneem Zehra ; Siegel, Robert J. / The usefulness of a 10% air-10% blood-80% saline mixture for contrast echocardiography : Doppler measurement of pulmonary artery systolic pressure. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 1. pp. 124-129.
@article{5b90257ebce74c3bb7623ed4f168edbd,
title = "The usefulness of a 10{\%} air-10{\%} blood-80{\%} saline mixture for contrast echocardiography: Doppler measurement of pulmonary artery systolic pressure",
abstract = "OBJECTIVES: We assessed an air-blood-saline mixture for Doppler measurement of pulmonary artery systolic pressure (PASP) and the mechanism of enhancement of the Doppler signal by this mixture. BACKGROUND: Underestimation of PASP by Doppler echocardiography occurs with inadequate continuous wave (CW) signals of tricuspid regurgitation (TR). METHODS: We assessed in vitro the diameter and concentration of microbubbles of agitated air-saline mixture, air-blood-saline mixture and 10{\%} air-10{\%} plasma-80{\%} saline mixture immediately, 5, 10 and 20 s after agitation. In 20 patients, PASP was estimated by Swan-Ganz catheter and CW Doppler of TR: 1) without contrast injection; 2) with intravenous injection of 10{\%} air-90{\%} saline; and 3) 10{\%} blood-10{\%} air-80{\%} saline mixture. RESULTS: Compared to air-saline, addition of blood or plasma to the air-saline solution significantly increased the concentration of microbubbles (p < 0.001). The air-blood-saline (26.7 ± 7.2 μ) and air-plasma-saline mixture (25.3 ± 7.4 μ) had smaller microbubbles than air-saline mixture (31.6 ± 8.2 μ) (p < 0.001). The correlation between Doppler- and catheter-measured PASP at baseline (r = 0.64) improved with agitated air-saline (r = 0.86). With the air-blood-saline mixture, the correlation further improved (r = 0.92) and the best limits of agreement were obtained. CONCLUSIONS: The combination of the patient's own blood is a method of making a sterile solution of numerous small microbubbles for injection into the right-sided cardiac chambers. Clinically, the air-blood-saline mixture is easily prepared at bedside and is superior to the air-saline mixture in assessing PASP in patients with inadequate CW Doppler signals.",
author = "Jeon, {Doo Soo} and Huai Luo and Takahiro Iwami and Takashi Miyamoto and Brasch, {Andrea V.} and James Mirocha and Naqvi, {Tasneem Zehra} and Siegel, {Robert J.}",
year = "2002",
month = "1",
day = "2",
doi = "10.1016/S0735-1097(01)01698-9",
language = "English (US)",
volume = "39",
pages = "124--129",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - The usefulness of a 10% air-10% blood-80% saline mixture for contrast echocardiography

T2 - Doppler measurement of pulmonary artery systolic pressure

AU - Jeon, Doo Soo

AU - Luo, Huai

AU - Iwami, Takahiro

AU - Miyamoto, Takashi

AU - Brasch, Andrea V.

AU - Mirocha, James

AU - Naqvi, Tasneem Zehra

AU - Siegel, Robert J.

PY - 2002/1/2

Y1 - 2002/1/2

N2 - OBJECTIVES: We assessed an air-blood-saline mixture for Doppler measurement of pulmonary artery systolic pressure (PASP) and the mechanism of enhancement of the Doppler signal by this mixture. BACKGROUND: Underestimation of PASP by Doppler echocardiography occurs with inadequate continuous wave (CW) signals of tricuspid regurgitation (TR). METHODS: We assessed in vitro the diameter and concentration of microbubbles of agitated air-saline mixture, air-blood-saline mixture and 10% air-10% plasma-80% saline mixture immediately, 5, 10 and 20 s after agitation. In 20 patients, PASP was estimated by Swan-Ganz catheter and CW Doppler of TR: 1) without contrast injection; 2) with intravenous injection of 10% air-90% saline; and 3) 10% blood-10% air-80% saline mixture. RESULTS: Compared to air-saline, addition of blood or plasma to the air-saline solution significantly increased the concentration of microbubbles (p < 0.001). The air-blood-saline (26.7 ± 7.2 μ) and air-plasma-saline mixture (25.3 ± 7.4 μ) had smaller microbubbles than air-saline mixture (31.6 ± 8.2 μ) (p < 0.001). The correlation between Doppler- and catheter-measured PASP at baseline (r = 0.64) improved with agitated air-saline (r = 0.86). With the air-blood-saline mixture, the correlation further improved (r = 0.92) and the best limits of agreement were obtained. CONCLUSIONS: The combination of the patient's own blood is a method of making a sterile solution of numerous small microbubbles for injection into the right-sided cardiac chambers. Clinically, the air-blood-saline mixture is easily prepared at bedside and is superior to the air-saline mixture in assessing PASP in patients with inadequate CW Doppler signals.

AB - OBJECTIVES: We assessed an air-blood-saline mixture for Doppler measurement of pulmonary artery systolic pressure (PASP) and the mechanism of enhancement of the Doppler signal by this mixture. BACKGROUND: Underestimation of PASP by Doppler echocardiography occurs with inadequate continuous wave (CW) signals of tricuspid regurgitation (TR). METHODS: We assessed in vitro the diameter and concentration of microbubbles of agitated air-saline mixture, air-blood-saline mixture and 10% air-10% plasma-80% saline mixture immediately, 5, 10 and 20 s after agitation. In 20 patients, PASP was estimated by Swan-Ganz catheter and CW Doppler of TR: 1) without contrast injection; 2) with intravenous injection of 10% air-90% saline; and 3) 10% blood-10% air-80% saline mixture. RESULTS: Compared to air-saline, addition of blood or plasma to the air-saline solution significantly increased the concentration of microbubbles (p < 0.001). The air-blood-saline (26.7 ± 7.2 μ) and air-plasma-saline mixture (25.3 ± 7.4 μ) had smaller microbubbles than air-saline mixture (31.6 ± 8.2 μ) (p < 0.001). The correlation between Doppler- and catheter-measured PASP at baseline (r = 0.64) improved with agitated air-saline (r = 0.86). With the air-blood-saline mixture, the correlation further improved (r = 0.92) and the best limits of agreement were obtained. CONCLUSIONS: The combination of the patient's own blood is a method of making a sterile solution of numerous small microbubbles for injection into the right-sided cardiac chambers. Clinically, the air-blood-saline mixture is easily prepared at bedside and is superior to the air-saline mixture in assessing PASP in patients with inadequate CW Doppler signals.

UR - http://www.scopus.com/inward/record.url?scp=0037005838&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037005838&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(01)01698-9

DO - 10.1016/S0735-1097(01)01698-9

M3 - Article

C2 - 11755297

AN - SCOPUS:0037005838

VL - 39

SP - 124

EP - 129

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 1

ER -