Publish in this journal
Journal Information
Vol. 43. Issue 2.
Pages 124-125 (March 2019)
Share
Share
Download PDF
More article options
Vol. 43. Issue 2.
Pages 124-125 (March 2019)
Images in Intensive Medicine
DOI: 10.1016/j.medin.2018.09.016
Full text access
Agitated saline echo testing: Two useful indications in critical care patients
Ecocardiograma con solución salina agitada: dos indicaciones útiles en pacientes críticos
Visits
277
P. Blancoa,
Corresponding author
ohtusabes@gmail.com

Corresponding author.
, G. Bellob
a Intensive Care Unit, Clínica Cruz Azul, Argentina
b Intensive Care Unit, “Hospital Central de las FF.AA. (DNSFFAA)”, Montevideo, Uruguay
This item has received
277
Visits
Article information
Full Text
Download PDF
Statistics
Figures (3)
Show moreShow less
Additional material (4)
Full Text

Agitated saline (bubble) transthoracic contrast echocardiography is a technique classically performed in diagnosing intracardiac and intrapulmonary shunts. However, there are other useful indications in critically ill patients. Typical preparation of the bubbles is shown in Video 1. One indication is in pericardiocentesis, proving the needle is in the pericardium and not in a cardiac chamber, after injecting the solution through the needle and observing the bubbles in the pericardial fluid (arrowheads, Fig. 1a, without bubbles in the pericardial fluid and b, with bubbles. Video 2; RA: right atrium; RV: right ventricle; LA: left atrium; LV: left ventricle). The second indication is for checking the adequate position of the central venous catheters when the rapid filling of the RA is observed (RA, Fig. 2a, before; and b, after injecting agitated saline through the catheter, arrowheads, and Video 3), and especially in left central venous catheters that descend through the left mediastinal border (Fig. 3a, arrows), allowing detecting that the catheter is in a persistent left superior vena cava emptying in the coronary sinus (CS), observing the filling of the CS (arrowheads) before the RA after injecting agitated saline through the catheter (Fig. 3b, before, and c; after injecting the agitated saline; Video 4), and thus ruling out an aberrant insertion (e.g. left internal mammary vein) and avoiding the unnecessary removal of the catheter and even the need of more sophisticated imaging techniques.

(0.12MB).
(0.16MB).
(0.19MB).
Funding

This work has not been supported by any grants.

Conflicts of interest

Authors have no conflicts of interest related to this submission.

Appendix A
Supplementary data

The following are the supplementary data to this article:

(0.65MB)
(2.81MB)
(5.23MB)
(2.95MB)

This work has not been presented at any conferences.

Copyright © 2018. Elsevier España, S.L.U. y SEMICYUC
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.