Category: Critical Care
Hypoxemic respiratory failure is a common presentation of critically ill patients. If the degree of hypoxemia is severe and disproportionate to the patient's radiographic findings and not responding to increasing FiO2, a right-to-left shunt should be considered. To evaluate for an anatomic shunt, an intravenous agitated saline contrast (ASC) echocardiographic evaluation can be conducted by an ED provider at the bedside.
Millington SJ, Mayo-Malasky H, Koenig S. Agitated saline contrast injection in patients with severe hypoxemia. J Intensive Care Med. 2023;38(5):479-486.