Document Detail


Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation.
MedLine Citation:
PMID:  16357385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of our study was to compare the effects of automated and manual carbon dioxide insufflation before CT colonography on distention and patient acceptance. SUBJECTS AND METHODS: One hundred forty-one symptomatic subjects underwent CT colonography using either an automated device (n = 47) or a manual method (n = 94) for carbon dioxide insufflation. CT data sets were assessed retrospectively in consensus by two blinded observers who graded distention for six colonic segments using a 4-point scale. An additional assessment of the overall clinical adequacy of distention (yes/no) was also made, and any learning curve was sought. Each patient completed a validated 24-point patient questionnaire reflecting patient satisfaction and discomfort. Distention scores, clinical adequacy, and questionnaire responses were analyzed using ordered logistic regression, Fisher's exact test, and the Mann-Whitney test statistic, respectively. RESULTS: Automated insufflation significantly improved distention overall (p = 0.001). For individual segments, distention was significantly improved in the sigmoid (p = 0.007) and descending (p < 0.001) colons when the patient was supine; and in the sigmoid (p = 0.02), descending (p = 0.001), and transverse (p = 0.02) colons when supine and prone positions were combined. No significant difference was seen in the clinical adequacy of distention, nor was there evidence of any learning curve for either insufflation method. Subjects were more weary after automated insufflation (p = 0.03), but no significant difference was seen for the remaining 23 questionnaire items or for feelings of bloating or discomfort. CONCLUSION: Automated carbon dioxide insufflation significantly improves colonic distention compared with manual insufflation. Benefit is greatest in the left colon, particularly when the patient is supine. Patient acceptance is similar to that for manual insufflation.
Authors:
David Burling; Stuart A Taylor; Steve Halligan; Louise Gartner; Mehjabeen Paliwalla; Chandani Peiris; Leanne Singh; Paul Bassett; Clive Bartram
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  186     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-16     Completed Date:  2006-02-16     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  96-103     Citation Subset:  AIM; IM    
Affiliation:
Department of Intestinal Imaging, St. Mark's and Northwick Park Hospitals, Harrow HA1 3UJ, UJK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Automation
Carbon Dioxide / diagnostic use*
Colonography, Computed Tomographic / methods*
Female
Humans
Image Processing, Computer-Assisted
Insufflation / methods*
Logistic Models
Male
Middle Aged
Patient Satisfaction
Retrospective Studies
Statistics, Nonparametric
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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