Vascular Ultrasonography: A Novel Method to Reduce Paracentesis Related Major Bleeding

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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 lowfrequency 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. Journal of Hospital Medicine 2018;13:30-33. Published online first October 18, 2017.

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