Cardiology Division, Brooke Army Medical Center, San Antonio, TX, USA.
Cardiovasc Ultrasound. 2020 Aug 17;18(1):35. doi: 10.1186/s12947-020-00215-0.
Up to 20% of resting echocardiograms obtained are suboptimal leading to further downstream testing and delays in diagnosis. Contrast enhanced echocardiography is well established and endorsed for use by the American Society of Echocardiography (ASE) in clinical scenarios when 2 or more adjacent wall segments are not well visualized; however, varied institutional protocols and practices in place limit such use due to increased time and personnel needed to obtain such imaging.
The purpose of this study was to determineif sonographer administered echo contrast led to decreased time to complete inpatient echocardiography exams when compared to the current institutional policy of having a registered nurse perform administration of contrast via a case-control approach. Sonographers received a one-day training course on the techniques for contrast administration. Baseline completion times (time from 1st image to last image) were reviewed in studies from March 2015 to May 2015. Sonographers who received training began self-administration of contrast the first week of June 2015. After a familiarization period, study completion times were recorded from September 2015 to December 2015 and compared to those during the baseline phase. Sonographers were not informed that they were being monitored. Patients and the public were not involved in the design or conduct of our study.
A total of 320 patients were included for analysis. Time spent obtaining contrast enhanced imaging was not significant between the two groups (p = 0.67). Time spent to complete each echocardiogram (time from first echocardiogram image to the last contrast enhanced echocardiogram image) was significant between the two groups (37.5 ± 10.9 min sonographer administered v 49.6 ± 12.5 min in nurse administered group, p < 0.001).
Utilizing a sonographer administered echo enhancement protocol results in reduced over 12 min of time saved per study.
多达 20%的静息超声心动图检查结果不理想，导致进一步的下游检查和诊断延迟。对比增强超声心动图已得到广泛认可，并被美国超声心动图学会（ASE）推荐用于 2 个或更多相邻壁段显示不佳的临床情况；然而，由于获得这种图像需要更多的时间和人员，因此不同机构的协议和实践限制了这种使用。
本研究的目的是确定与当前机构政策相比，由超声技师进行超声造影剂给药是否会缩短住院患者超声心动图检查的完成时间，该政策规定由注册护士通过病例对照方法进行造影剂给药。超声技师接受了为期一天的造影剂给药技术培训课程。在 2015 年 3 月至 2015 年 5 月的研究中，回顾了基础完成时间（从第一幅图像到最后一幅图像的时间）。接受培训的超声技师在 2015 年 6 月的第一周开始自行给药。在熟悉期后，从 2015 年 9 月至 12 月记录研究完成时间，并与基础期进行比较。超声技师不知道他们正在接受监测。患者和公众未参与我们研究的设计或实施。
共有 320 名患者纳入分析。两组之间获得对比增强图像的时间没有显著差异（p=0.67）。两组之间完成每个超声心动图的时间（从第一幅超声心动图图像到最后一幅对比增强超声心动图图像的时间）有显著差异（由超声技师给药的时间为 37.5±10.9 分钟，由护士给药的时间为 49.6±12.5 分钟，p<0.001）。
使用超声技师给药的超声增强方案可节省每例研究超过 12 分钟的时间。
