SU1641280A1 - Method for echocardiography - Google Patents

Abstract

This invention relates to ultrasound diagnostics in cardiology. The purpose of the invention is the prevention of complications in echocardiography. Introduce intravenously through the catheter a 10-20% solution of lipofundin in an amount of 3-4 ml in a bolus in the aerated state, after which 5-8 ml of physiological saline are injected. The method allows with high diagnostic efficiency to carry out the contrasting chambers of the heart, and in no case were any complications noted.

Description

This invention relates to medicine, namely to ultrasound diagnostics in cardiology.

The aim of the invention is to prevent complications.

The method is carried out as follows.

A catheterization of one of the peripheral veins is carried out with a teflon catheter with a diameter of 1.1 mm and a length of 2.5 cm, after which a contrast agent is rapidly injected intravenously. Fat emulsions of soybean oil of 20% concentration (lipofundin, intralipid) with the size of the main mass of particles of the dispersed phase less than {l. Saline was chosen as a control contrast agent as the safest and most frequently used agent for this purpose.

The severity of the effect of ultrasound contrast is evaluated on a 4-point scale - from single bubbles found in the chambers of the heart and large vessels (+), until they are completely filled with contrast (++++). In addition, the duration of the contrast effect is taken into account — the number of cardiocycles during which the contrast was detected.

With the rapid intravenous administration of 5-10 ml of physiological solution, contrasting was obtained in 9 patients. Of these, three were rated as (+), and six (+). With prior artificial aeration of a physiological solution immediately prior to administration by means of a series of quick sets of it from a sterile vial into a syringe and releasing the number back. Positive results were 16 with a contrast ratio of (+) y 3, (++) y 5 and (+++) y 8 patients.

Rapid intravenous administration of 3-5 ml of lipofundin or intralipid with immediate subsequent administration of 5 to 10 ml of physiological saline allowed us to obtain long-lasting contrast chambers of the heart in all patients with a degree of effect (4+) in 7 and (+++) in 13. With a preliminary

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artificial aeration of the fat emulsion, administered in the same amount, the degree of contrast was (+ -H- +) in 17 patients and {+++} ultrasound.

The expression of the lipofundin and intralipid-induced contrast was the same.

In one study, up to 30 ml of the fat emulsion was injected, with intervals of three to five minutes. Both saline and fat emulsions did not cause side effects.

Example. Patient with a diagnosis of atrial septal defect.

4.0 ml of lipofundin fat emulsion with a 20% concentration were immediately injected into the patient through a catheter installed in the peripheral vein with immediate subsequent administration of 5.0 ml of saline. At the same time, a pronounced counter test of the heart chambers was achieved.

PRI mme R 2. Sick with a diagnosis of ischemic heart disease, atherosclerotic cardiosclerosis, aortic valve insufficiency, mitral valve insufficiency.

The patient, through a catheter installed in the peripheral vein, was quickly injected with 3.0 ml of pre-aerated lipofundin fat emulsion of 20% concentration with immediate subsequent administration of 8.0 ml of saline. Aeration is performed by a series of quick dialing of a fat emulsion from a sterile vial into a syringe and discharging it back into a vial. At the same time, a pronounced contrast effect was obtained, which is not inferior in density to echo signals from heart structures. An ultrasound contrast study allowed us to reveal an atrial septal defect in one patient on the basis of a contrast discharge from the right atrium to the left, and in a patient with acute myocardial infarction, a detected contrast loss from the right ventricle to the left one confirmed the interventricular fracture.

partitions. In three patients with suspected atrial septal defect and in one with suspected ventricular septum defect, these conditions were excluded as there were no contrast-induced intracardiac contrast discharges, or zones in the right atrium and right atrium and right ventricle, the so-called negative contrasting. On the basis of a narrowed jet of contrast through the valve of the pulmonary artery and its delay in the output section of the right ventricle in one patient, the diagnosis was stopped: valve stenosis of the pulmonary artery. In patients with coronary heart disease, echocardiography made it possible to examine the parietal blood flow and, by the duration of the delayed contrast in the cardiac cavity, judge the presence and severity of cardio. failure.

Claims (1)

Thus, this study showed high efficiency of fat emulsions as a contrast agent for ultrasound diagnostics, the safety of their use for this purpose, and they allowed to obtain a pronounced ultrasound contrast in cases where the use of saline did not give the desired result, which was often observed in patients with slower blood flow caused by heart failure. In no case were there any complications after administration of the contrast agent. Claims of echocardiography by administering a contrast agent, characterized in that fat emulsions are used as a contrast agent in order to prevent complications, and the study is carried out after intravenous administration of a 10-20% lipofundin solution in an amount of 3 - A ml in a bolus in the aerated state, after which 5-8 ml of physiological saline are injected.