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Pulmonary scintigraphy at the bedside in intensive care patients with suspected pulmonary embolism
P Jolliet1, D O Slosman, B Ricou
1Soins Intensifs de Médecine, Hôpital Cantonal Universitaire, Geneva 14, Switzerland.
Objective:
Performance of pulmonary scintigraphy (PS) for suspected pulmonary embolism (PE) in ICU patients normally involves the added risk of transporting unstable patients to the nuclear medicine unit (NMU) and poses technical difficulties in ventilating intubated patients. This retrospective study addresses the feasibility of performing PS as the bedside.
Material And Methods:
During a 2-year period, all ICU patients with suspected PE underwent PS at the bedside, performed with a mobile gamma-camera. 99mTc-labelled albumin macroaggregates were used for the perfusion studies. Gasified 99mTc or 81mKr gas was administered by an adapting technique in intubated patients.
Results:
45 patients were studied, 29 (64%) of whom were intubated and 21 (47%) of whom were in shock. PE was confirmed or excluded by PS in 49% of patients. Angiography was performed in 4 patients (8%). In the rest, a combination of low clinical and low or very low PS probabilities rendered PE highly unlikely. There was no evidence of PE in the subsequent follow-up.
Conclusions:
In ICU patients with suspected PE, PS can be performed at the bedside with a mobile gamma-camera. The risk of transporting unstable patients can thus be avoided.