Covi Stuart H, Whiteside Wendy, Yu Sunkyung, Zampi Jeffrey D
Department of Pediatrics, University of Michigan, Ann Arbor, Mich, USA.
Congenit Heart Dis. 2015 Mar-Apr;10(2):E43-7. doi: 10.1111/chd.12197. Epub 2014 Jun 26.
To determine if lower starting pulse fluoroscopy rates lead to lower overall radiation exposure without increasing complication rates or perceived procedure length or difficulty.
The pediatric cardiac catheterization laboratory at University of Michigan Mott Children's Hospital.
Pediatric patients with congenital heart disease.
DESIGN/INTERVENTIONS: We performed a single-center quality improvement study where the baseline pulse fluoroscopy rate was varied between cases during pediatric cardiac catheterization procedures.
Indirect and direct radiation exposure data were collected, and the perceived impact of the fluoroscopy rate and procedural complications was recorded. These outcomes were then compared among the different set pulse fluoroscopy rates.
Comparing pulse fluoroscopy rates of 15, 7.5, and 5 frames per second from 61 cases, there was a significant reduction in radiation exposure between 15 and 7.5 frames per second. There was no difference in perceived case difficulty, procedural length, or procedural complications regardless of starting pulse fluoroscopy rate.
For pediatric cardiac catheterizations, a starting pulse fluoroscopy rate of 7.5 frames per second exposes physicians and their patients to significantly less radiation with no impact on procedural difficulty or outcomes. This quality improvement study has resulted in a significant practice change in our pediatric cardiac catheterization laboratory, and 7.5 frames per second is now the default fluoroscopy rate.
确定较低的起始脉冲透视率是否能在不增加并发症发生率、不延长感知的手术时长或难度的情况下降低总体辐射暴露量。
密歇根大学莫特儿童医院的儿科心导管实验室。
患有先天性心脏病的儿科患者。
设计/干预措施：我们开展了一项单中心质量改进研究，在儿科心导管手术过程中，不同病例的基线脉冲透视率有所不同。
收集间接和直接辐射暴露数据，并记录透视率和手术并发症的感知影响。然后对不同设定的脉冲透视率下的这些结果进行比较。
比较61例病例中每秒15帧、7.5帧和5帧的脉冲透视率，每秒15帧和7.5帧之间的辐射暴露量有显著降低。无论起始脉冲透视率如何，在感知的病例难度、手术时长或手术并发症方面均无差异。
对于儿科心导管手术，起始脉冲透视率为每秒7.5帧可使医生及其患者受到的辐射显著减少，且对手术难度或结果无影响。这项质量改进研究已使我们儿科心导管实验室的实践发生了重大改变，现在默认的透视率为每秒7.5帧。
