Thanks for the help. Ann
-----Original Message-----
From: Michael, Dwight [mailto:[log in to unmask]]
Sent: Tuesday, November 19, 2002 12:43 PM
To: [log in to unmask]
Subject: Re: Renal Artery Duplex with Ultrasound Contrast
Anyone who has been approved to administer IV medications can give contrast.
In our institution Registered Technologists or RNs may administer contrast.
We have standing orders for the use of contrast for echo. Only the Medical
Director or I can use contrast for vascular applications (and the "I" is
only because he will cover me).
-----Original Message-----
From: Needham, Ann [mailto:[log in to unmask]]
Sent: Tuesday, November 19, 2002 10:31 AM
To: [log in to unmask]
Subject: Re: Renal Artery Duplex with Ultrasound Contrast
Michael,
Who does the injections for contrast use? Do you have a physician present,
order, or do you or a nurse do these? Thanks,
Ann Needham, RN RVT
Vascular Diagnostic Services
Chattanooga, TN
-----Original Message-----
From: Michael, Dwight [mailto:[log in to unmask]]
Sent: Monday, November 18, 2002 5:40 PM
To: [log in to unmask]
Subject: Re: Renal Artery Duplex with Ultrasound Contrast
Elain, I have used Definity for renal arteries. It provides excellent color
enhancement and makes extremely difficult to impossible to do patients,
doable. I've used it several ways and the most effective for me seems to be
mixing the Definity in 200-250 ml IV solution, (normal saline, D5W, etc). I
usually do not turn on the contrast until I'm ready to look at flow in the
kidney and arteries. At that point I titrate the drip rate to provide
adequate enhancement (but not so fast as to use up all my contrast on one
side.) If you've never used contrast, beware. You can get overpowered with
color. Use the lowest Mechanical Index possible. You should use a MI of
less than 0.6 in order not to destroy the "bubbles". I've not tried Optison
for renals. We no longer use it at all. Optison settles out in solution
and would be very difficult to maintain in suspension for continuous drip.
I've used the Definity with small bolus injections, as well as less dilution
(100 cc), The 200-250 cc solution seems to work best for me. Good Luck! I
hope this has been of some benefit.
-----Original Message-----
From: Elaine Erickson [mailto:[log in to unmask]]
Sent: Sunday, November 17, 2002 8:58 PM
To: [log in to unmask]
Subject: Renal Artery Duplex with Ultrasound Contrast
Hi,
Has anyone out there had experience with bubble contrast to enhance renal
artery studies. If so, I would be interested in your opinion as to whether
or not sufficient optimization resulted from the use of contrast, and what
protocol was followed to achieve the maximum benefits. I currently work
for cardiologists, but my previous experience has been limited to abdominal
and peripheral exams. The cardiologists do rely on Optison for cardiac
imaging on some technically difficult patients, and was curious if anyone
has had experience in other applications of bubble contrast.
Thank you,
Elaine Erickson
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