Continuous real-time computation and display of systolic time intervals from surgical patients.
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Biomedical subjects
Publications and source records attributed to J C Hung.
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BACKGROUND: Adenoscan (Fujisawa USA, Inc., Deerfield, Ill.) has been initially packaged in a 30 ml glass vial for single use only because it contains no preservative. This restricted usage has generated considerable waste and high cost for the patient. Although the new 20 ml vial of Adenoscan provides some reduction in waste, the savings offered by the 20 ml and 30 ml vial system is still not optimal. The purpose of this study was to investigate an optimal dual-size vial system that would provide limited amounts of waste while maintaining its practicality to satisfy different patient populations. MATERIALS AND RESULTS: The least waste for each potential combination (n = 344) of two vials was calculated by assuming that patient weights (30 to 200 kg) follow a normal distribution. The 6 ml and 15 ml vial combination had the least expected waste for lighter patient populations, and the 9 ml and 15 ml vial system had the least expected waste for heavier populations. The calculated wastes for 4207 patients (83 +/- 19 kg) undergoing adenosine stress myocardial perfusion studies at the Mayo Clinic were 10.5 +/- 9.3 ml (30 ml vial), 5.1 +/- 2.9 ml (20 ml and 30 ml vial system), 1.6 +/- 1.0 ml (6 ml and 15 ml vial system), and 1.8 +/- 1.2 ml (9 ml and 15 ml vial system). CONCLUSIONS: In general, both the 6 ml and 15 ml and 9 ml and 15 ml vial systems perform better than either the single 30 ml vial or the 20 ml and 30 ml vial system. Furthermore, the 6 ml and 15 ml vial combination offers the lowest expected waste for the actual patient population that underwent the adenosine stress myocardial perfusion imaging studies at our institution.
OBJECTIVE: To assess commercial macroaggregated albumin (MAA) reagent kits for compliance with particle-size parameters needed for proper clinical evaluation of pulmonary shunts (right-to-left). DESIGN: Comparative trial. SETTING: Nuclear pharmacy (laboratory setting). PATIENTS AND OTHER PARTICIPANTS: Not applicable. INTERVENTIONS: Minimally, 90% of the particles contained within an MAA reagent kit should be within the 10 to 90 microns range with minimal variation in particle size distribution and as few small particles (i.e., < 10 microns) as possible. Five separate vials from five commercial brands of MAA reagent kits were obtained, and 500 to 517 particles were analyzed for each sample. An additional study was performed on one of the MAA reagent kit brands, using five vials from each of five different lot numbers to determine the variability between lots. MAIN OUTCOME MEASURES: Long axis (maximum, micron), short axis (minimum, micron), and the area (micron 2) of each MAA particle. RESULTS: One MAA brand had the lowest percentage of unacceptable MAA particle sizes and maintained consistent particle sizes between vials. However, the same MAA reagent kit brand showed that only two of five lots had a low percentage of MAA particle sizes below the 10-micron limit. CONCLUSION: Particle sizes varied among the five different brands of MAA reagent kits, as did different lots of the best-performing kit. This variability in particle sizes may affect the accuracy and reproducibility of pulmonary shunt patient studies.