Pulmonary scintigraphy at the bedside in intensive care patients with suspected pulmonary embolism.

OBJECTIVE

Performance of pulmonary scintigraphy (PS) for suspected pulmonary embolism (PE) in ICU patients normally involves the added risk of transporting unstable patients to the nuclear medicine unit (NMU) and poses technical difficulties in ventilating intubated patients. This retrospective study addresses the feasibility of performing PS as the bedside.

MATERIAL AND METHODS

During a 2-year period, all ICU patients with suspected PE underwent PS at the bedside, performed with a mobile gamma-camera. 99mTc-labelled albumin macroaggregates were used for the perfusion studies. Gasified 99mTc or 81mKr gas was administered by an adapting technique in intubated patients.

RESULTS

45 patients were studied, 29 (64%) of whom were intubated and 21 (47%) of whom were in shock. PE was confirmed or excluded by PS in 49% of patients. Angiography was performed in 4 patients (8%). In the rest, a combination of low clinical and low or very low PS probabilities rendered PE highly unlikely. There was no evidence of PE in the subsequent follow-up.

CONCLUSIONS

In ICU patients with suspected PE, PS can be performed at the bedside with a mobile gamma-camera. The risk of transporting unstable patients can thus be avoided.