[abstract] ABILITY TO VISUALIZE CIRCULATING DECOMPRESSION-INDUCED GAS EMBOLI BY PORTABLE TRANSTHORACIC ECHOCARDIOGRAPHY INCREASES WITH INCREASING PRECORDIAL DOPPLER GRADE.

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[abstract] ABILITY TO VISUALIZE CIRCULATING DECOMPRESSION-INDUCED GAS EMBOLI BY PORTABLE TRANSTHORACIC ECHOCARDIOGRAPHY INCREASES WITH INCREASING PRECORDIAL DOPPLER GRADE.

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Title: [abstract] ABILITY TO VISUALIZE CIRCULATING DECOMPRESSION-INDUCED GAS EMBOLI BY PORTABLE TRANSTHORACIC ECHOCARDIOGRAPHY INCREASES WITH INCREASING PRECORDIAL DOPPLER GRADE.
Author: Pollock, NW
Abstract: INTRODUCTION: Decompression is associated with gas emboli (bubble) formation. Doppler ultrasound provides a surrogate measure of decompression stress, by aurally identifying bubbles in the blood, typically leaving the right heart for the lungs. While the lungs are an effective bubble filter, several avenues exist for left ventricular gas emboli to arise, potentially creating an elevated risk of neurological decompression sickness. Recently developed, portable two-dimensional transthoracic echocardiographic imaging (TTE) systems facilitate left heart monitoring under laboratory or field conditions. An unresolved question is whether portable TTE is as sensitive as Doppler to bubble presence. METHODS: Subjects in our decompression studies are routinely evaluated with precordial Doppler (TechnoScientific DBM9008) and, more recently, with TTE (SonoSite SonoHeart Elite). Doppler scores were reported using the 0-IV grade Spencer scale. TTE scans focused on the left heart but the presence/absence of right heart bubbles was recorded if that field was also interpretable. This study compared monitoring periods for which both Doppler and left and right heart TTE data were available. Chi squared testing assessed differences in TTE-identified bubbles across Doppler grades. RESULTS: A total of 2734 records were reviewed. The ability to identify bubbles with TTE progressively increased with increasing Doppler grade. Doppler grade 0 = 2.3% TTE-detected VGE (49/2159); grade I=23.3% (34/146); grade II=55.8% (126/226); grade III=81.7% (125/153); and grade IV=98% (49/50). All paired contrasts were significantly different (Chi squared[1] I vs. II = 38.1; II vs. III = 27.5; III vs. IV = 8.2). CONCLUSIONS: Portable TTE devices facilitate left heart monitoring during decompression studies not feasible with Doppler. Portable TTE devices do appear to be more able to detect circulating bubbles when Doppler-detected grades are higher. The relative insensitivity of portable TTE to lower bubble grades indicates that scoring provided by the different technologies may not be fully comparable.
Description: Abstract of the Undersea & Hyperbaric Medical Society 2008 Annual Scientific Meeting June 26-28, 2008 Salt Lake City Marriott Downtown, Salt Lake City, Utah.
URI: http://archive.rubicon-foundation.org/7791
Date: 2008

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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