Forum topic

I'm looking for evidence or any supporting literature in reference to "bubble studies."  I'd never heard of bubble studies before and everyone may be doing them I just can't find any available literature. 

For those not familiar with bubble studies,they are done during both TEEs and TTEs.  The nurse mixes one ml of air into 9 ml of sterile saline (agitating the saline by forcing it between two syringes connected by a stopcock).  When the technician and/or physician is ready, the saline (containing 1 ml of bubbles) is released through the stopcock and into the patient in order to see if the champagne of bubbles crosses the ventricular septum.  It creates a pretty casade on the echo screen rather like fireflies dancing across the heart.

Anyway, the staff nurses are concerned about the practice esp. since the procedure may be repeated 3 or more times to insure an adequate echo study.  Is this a case of no-harm-no-foul or should we be concerned with this practice? 

Thanks in advance, 

nancy s.