Evaluating the potential risks of bubble studies during echocardiography

Area of Science:

• Cardiovascular imaging
• Medical device engineering

Background:

• Cardiac shunts are diagnosed using echocardiography bubble studies with agitated saline.
• Previous recommendations for agitated saline volumes vary, posing a risk of air microembolism.

Purpose of the Study:

• To quantify the bubble characteristics generated by different volumes of agitated saline.
• To identify a safer air volume for bubble studies to mitigate microembolism risk.

Main Methods:

• A closed circuit system with a ventricular assist pump and reservoir was used.
• Agitated saline (0.5 mL, 1 mL, 2 mL air in 10 mL total volume) was injected, and bubble size/volume measured using an EDAC sensor.
• Each bolus was tested 20 times to ensure reliability.

Main Results:

• The study identified potential risks associated with air administration during bubble studies.
• A safer air volume for agitated saline administration was proposed based on bubble quantification.

Conclusions:

• Further research is needed to establish guidelines for agitated saline administration.
• Standardization by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) is recommended to minimize air microembolism risks.