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Vascular Ultrasonography: A Novel Method to Reduce Paracentesis Related Major Bleeding
Author(s) -
Barsuk Jeffrey H.,
Rosen Bradley T.,
Cohen Elaine R.,
Feinglass Joe,
Ault Mark J.
Publication year - 2018
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.2863
Subject(s) - medicine , paracentesis , ultrasound , ultrasonography , high frequency ultrasound , surgery , radiology , ascites
Paracentesis is a core competency for hospitalists. Using ultrasound for fluid localization is standard practice and involves a low‐frequency probe. Experts recommend a “2‐probe technique,” which incorporates a high‐frequency ultrasound probe in addition to the low‐frequency probe to identify blood vessels within the intended needle path. Evidence is currently lacking to support this 2‐probe technique, so we performed a pre‐ to postintervention study to evaluate its effect on paracentesis‐related bleeding complications. From February 2010 to August 2011, procedures were performed using only low‐frequency probes (preintervention group), while the 2‐probe technique was used from September 2011 to February 2016 (postintervention group). A total of 5777 procedures were performed. Paracentesis‐related minor bleeding was similar between groups. Major bleeding was lower in the postintervention group (3 [0.3%], n = 1000 vs 4 [0.08%], n = 4777; P = .07). This clinically meaningful trend suggests that using the 2‐probe technique might prevent paracentesis‐related major bleeding.