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Riggs BJ, Martinez-Correa S, Stern J, Tierradentro-Garcia LO, Haddad S, Anupindi S, Back SJ, Darge K, Hwang M. Intravenous administration of ultrasound contrast to critically ill pediatric patients. Pediatr Radiol 2024; 54:820-830. [PMID: 38506945 DOI: 10.1007/s00247-024-05898-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The off-label use of contrast-enhanced ultrasound has been increasingly used for pediatric patients. OBJECTIVE The purpose of this retrospective study is to report any observed clinical changes associated with the intravenous (IV) administration of ultrasound contrast to critically ill neonates, infants, children, and adolescents. MATERIALS AND METHODS All critically ill patients who had 1 or more contrast-enhanced ultrasound scans while being closely monitored in the neonatal, pediatric, or pediatric cardiac intensive care units were identified. Subjective and objective data concerning cardiopulmonary, neurological, and hemodynamic monitoring were extracted from the patient's electronic medical records. Vital signs and laboratory values before, during, and after administration of ultrasound contrast were obtained. Statistical analyses were performed using JMP Pro, version 15. Results were accepted as statistically significant for P-value<0.05. RESULTS Forty-seven contrast-enhanced ultrasound scans were performed on 38 critically ill patients, 2 days to 17 years old, 19 of which were female (50%), and 19 had history of prematurity (50%). At the time of the contrast-enhanced ultrasound scans, 15 patients had cardiac shunts or a patent ductus arteriosus, 25 had respiratory failure requiring invasive mechanical oxygenation and ventilation, 19 were hemodynamically unstable requiring continual vasoactive infusions, and 8 were receiving inhaled nitric oxide. In all cases, no significant respiratory, neurologic, cardiac, perfusion, or vital sign changes associated with IV ultrasound contrast were identified. CONCLUSION This study did not retrospectively identify any adverse clinical effects associated with the IV administration of ultrasound contrast to critically ill neonates, infants, children, and adolescents.
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Affiliation(s)
- Becky J Riggs
- Division of Pediatric Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Santiago Martinez-Correa
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Joseph Stern
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Luis Octavio Tierradentro-Garcia
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sophie Haddad
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Sudha Anupindi
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA.
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
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2
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Verma N, Steigner ML, Aghayev A, Azene EM, Chong ST, Desjardins B, El Khouli RH, Harrison NE, Hedgire SS, Kalva SP, Lee YJ, Mauro DM, Mehta HJ, Meissner M, Pillai AK, Singh N, Suranyi PS, Williamson EE, Dill KE. ACR Appropriateness Criteria® Suspected Retroperitoneal Bleed. J Am Coll Radiol 2021; 18:S482-S487. [PMID: 34794602 DOI: 10.1016/j.jacr.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
The initial diagnosis of retroperitoneal bleeding can be challenging by physical examination and clinical presentation. Prompt imaging can make the diagnosis and be lifesaving. When selecting appropriate imaging for these patient's, consideration must be made for sensitivity and ability to image the retroperitoneum, as well as speed of imaging.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Nupur Verma
- Program Director, Radiology, University of Florida, Gainesville, Florida.
| | - Michael L Steigner
- Panel Chair; and Director, Vascular CT/MR, and Medical Director, 3D Lab, Brigham & Women's Hospital, Boston, Massachusetts
| | - Ayaz Aghayev
- Panel Vice-Chair, Brigham & Women's Hospital, Boston, Massachusetts
| | | | - Suzanne T Chong
- Indiana University, Indianapolis, Indiana; and Chair, ER Committee, ACR GSER Commission
| | | | - Riham H El Khouli
- Director, Theranostic Program and Chair, NM&MI Clinical Protocol and Quality Improvement (CPQI) Committee, University of Kentucky, Lexington, Kentucky
| | - Nicholas E Harrison
- Wayne State University, Detroit, Michigan; American College of Emergency Physicians
| | - Sandeep S Hedgire
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sanjeeva P Kalva
- Chief, Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts; International Editor, Journal of Clinical Interventional Radiology ISVIR; and Assistant Editor, Radiology - Cardiothoracic, RSNA
| | - Yoo Jin Lee
- University of Virginia Medical Center, Charlottesville, Virginia
| | - David M Mauro
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Hiren J Mehta
- University of Florida College of Medicine, Gainesville, Florida; Primary care physician - critical care
| | - Mark Meissner
- University of Washington School of Medicine, Seattle, Washington; President, American Vein & Lymphatic Society; At-Large Board Member, Intersocietal Accreditation Commission; General Secretary, International Union of Phlebology; and Society for Vascular Surgery
| | - Anil K Pillai
- Section Chief, UT Southwestern Medical Center, Dallas, Texas
| | | | - Pal S Suranyi
- Medical University of South Carolina, Charleston, South Carolina
| | - Eric E Williamson
- Mayo Clinic, Rochester, Minnesota; Society of Cardiovascular Computed Tomography
| | - Karin E Dill
- Specialty Chair, Emory University Hospital, Atlanta, Georgia
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3
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Kessner R, Nakamoto DA, Kondray V, Partovi S, Ahmed Y, Azar N. Contrast-Enhanced Ultrasound Guidance for Interventional Procedures. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2541-2557. [PMID: 30714653 DOI: 10.1002/jum.14955] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Since its introduction, contrast-enhanced ultrasound (CEUS) has gained an important role in the diagnosis and management of abdominal and pelvic diseases. Contrast-enhanced ultrasound can improve lesion detection rates as well as success rates of interventional procedures when compared to conventional ultrasound alone. Additionally, CEUS enables the interventionalist to assess the dynamic enhancement of different tissues and lesions, without the adverse effects of contrast-enhanced computed tomography, such as exposure to ionizing radiation and nephrotoxicity from iodinated contrast material. This review article describes the various applications and advantages of the use of CEUS to enhance performance of ultrasound-guided interventions in the abdomen and pelvis.
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Affiliation(s)
- Rivka Kessner
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dean A Nakamoto
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Victor Kondray
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasan Partovi
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yasmine Ahmed
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nami Azar
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
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4
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Wang M, Sui J, Wang S, Wang X. Correlations of carotid intima-media thickness with endothelial function and atherosclerosis degree in patients with type 2 diabetes mellitus. Clin Hemorheol Microcirc 2019; 72:431-439. [PMID: 31006671 DOI: 10.3233/ch-180486] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Minxin Wang
- Department of Ultrasound, Weihai Central Hospital, Weihai, Shandong, China
| | - Jingshu Sui
- Department of Ultrasound, Weihai Central Hospital, Weihai, Shandong, China
| | - Shuang Wang
- Department of Ultrasound, Weihai Central Hospital, Weihai, Shandong, China
| | - Xiaoting Wang
- Department of Ultrasound, Weihai Central Hospital, Weihai, Shandong, China
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5
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Negrão de Figueiredo G, Mueller-Peltzer K, Zengel P, Armbruster M, Rübenthaler J, Clevert D. Diagnostic performance of contrast-enhanced ultrasound (CEUS) for the evaluation of gallbladder diseases1. Clin Hemorheol Microcirc 2018; 69:83-91. [DOI: 10.3233/ch-189116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Negrão de Figueiredo
- Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians- University of Munich – Grosshadern Campus, Marchioninistr, Munich, Germany
| | - K. Mueller-Peltzer
- Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians- University of Munich – Grosshadern Campus, Marchioninistr, Munich, Germany
| | - P. Zengel
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - M. Armbruster
- Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians- University of Munich – Grosshadern Campus, Marchioninistr, Munich, Germany
| | - J. Rübenthaler
- Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians- University of Munich – Grosshadern Campus, Marchioninistr, Munich, Germany
| | - D.A. Clevert
- Department of Radiology, Interdisciplinary Ultrasound-Center Ludwig-Maximilians- University of Munich – Grosshadern Campus, Marchioninistr, Munich, Germany
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6
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Jung EM, Jung F, Xu HX. Developments in the application of high resolution ultrasound in clinical diagnostics. Clin Hemorheol Microcirc 2017; 66:273-275. [PMID: 28527197 DOI: 10.3233/ch-179100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ernst-Michael Jung
- Department of Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany
| | - Friedrich Jung
- Institute of Biomaterial Science and Berlin-Brandenburg Centre for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University, School of Medicine, Shanghai, China
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