A Comparative Study On Hand-agitated Saline Solution With Blood,Hand-agitated 50% Glucose Solution And Hand-agitated Saline Solution In Contrast Transthoracic Echocardiography And Contrast Transcranial Doppler

Objective: To compare the stability,effectiveness,sensitivity and safety of hand-agitated saline with blood,hand-agitated 50% glucose and hand-agitated saline solution,provide reference points in clinical examination.To evaluate the right to left shunt positive detection rates of contrast transthoracic echocardiography and contrast transcranial doppler,during the resting state and the Valsalva maneuver.Methods: One hundred and five inpatients or outpatients suspected of RLS(cryptogenic stroke,transient ischemic attack,migraine with aura)in the Third People's Hospital of Chengdu and the Affiliated Hospital of Chengdu University.All patients underwent contrast transthoracic echocardiography and contrast transcranial doppler,in which three different contrast agents had been hand-agitated for 20 times.Monitor the right heart microbubbles developing time of three groups and right to left shunt.Semi-quantitatively analyzed the right to left shunt.Evaluate the right to left shunt positive detection rates of contrast transthoracic echocardiography and contrast transcranial doppler,during the resting state and the Valsalva maneuver.Monitor the change of heart rate,respiratory rate,oxygen saturation.Results: The right heart microbubbles developing time of hand-agitated saline with blood and hand-agitated 50%glucose are longer than hand-agitated saline,the difference was statistically significant(P<0.01);the microbubbles developing time of hand-agitated saline with blood are longer than hand-agitated 50%glucose,the difference was statistically significant(P < 0.05).The hand-agitated saline with blood and hand-agitated50% glucose had a higher detection rate than hand-agitated saline,the difference was statistically significant(P <0.05);although the detection rate between hand-agitated saline with blood and hand-agitated 50% glucose have no statistics significance(P >0.05),hand-agitated saline with blood was more sensitive in detection of Grade ? and Grade?,the difference was statistically significant(P<0.05).The right to left shunt positive detection rates of contrast transthoracic echocardiography and contrast transcranial doppler are higher during the Valsalva maneuver,the difference was statistically significant(P <0.05).All patient's change of heart rate,respiratory rate and oxygen saturation had no statistics significance(P > 0.05).Conclusions: Hand-agitated saline with blood and hand-agitated 50% glucose are two cost-effective,safe,effective right heart contrast agents.Especially,the contrast effect of hand-agitated saline with blood is better than traditional hand-agitated saline.Hand-agitated saline with blood is easy to prepare and deserves extensive application.The modified Valsalva maneuver is conducive to increase the positive rate of contrast transthoracic echocardiography and contrast transcranial doppler.