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[Angiography in intensive care medicine]
K Lackner1, P Landwehr, G Ertl
1Institut für Röntgendiagnostik, Universität Würzburg.
Rontgen-Blatter; Zeitschrift Fur Rontgen-Technik Und Medizinisch-Wissenschaftliche Photographie
|July 1, 1989
Summary
Angiography in intensive care is uncommon but indicated for critical conditions like pulmonary embolism or gastrointestinal bleeding. The decision requires balancing patient transport risks against potential therapeutic benefits from this invasive diagnostic procedure.
Area of Science:
- Vascular Medicine
- Interventional Radiology
- Critical Care Medicine
Background:
- Angiography is infrequently utilized within the intensive care unit (ICU) setting.
- Specific clinical scenarios necessitate its consideration despite the inherent risks.
- The ICU environment presents unique challenges for invasive procedures.
Purpose of the Study:
- To outline the primary indications for performing angiography in the ICU.
- To emphasize the critical risk-benefit analysis required before proceeding.
- To inform clinical decision-making regarding invasive vascular diagnostics in critically ill patients.
Main Methods:
- Review of clinical indications for ICU angiography.
- Discussion of the risks associated with patient transport and invasive procedures.
- Evaluation of the potential therapeutic gains versus procedural risks.
Main Results:
- Key indications include pulmonary embolism, unstable angina/myocardial infarction, gastrointestinal hemorrhage, acute arterial occlusion, and vascular trauma.
- Foreign body extraction is also a potential indication.
- The decision-making process involves a careful assessment of procedural risks and expected benefits.
Conclusions:
- Angiography in the ICU is reserved for specific, high-stakes clinical situations.
- A thorough risk-benefit assessment, considering transport and procedural dangers, is paramount.
- The potential for significant therapeutic gain must outweigh the associated risks.