Anaesthetists and surgeons involved with the liver transplant programme in Birmingham are making excellent use of HDI 3500 and HDI 5000 instruments from Philips Ultrasound
Anaesthetists and surgeons involved with the liver transplant programme at Birmingham Children's Hospital and the Queen Elizabeth Hospital in Birmingham are making excellent use of HDI 3500 and HDI 5000 instruments from Philips Ultrasound.
James Bennett, consultant anaesthetist at the Children's Hospital, explained why he began to use ultrasound: "I was conscious of difficulties we were having with a group of complicated patients who had many previous central lines.
"Central venous access was proving hazardous, not least because many of this group had severe coagulopathies and low platelet counts. "A radiologist, who has since left the hospital, taught me how to use ultrasound to help with venous access in these patients." This was three years ago and, as far as they are aware, Bennett and his colleague Peter Bromley were the first anaesthetists to start using vascular ultrasound.
Since then, in 2002, a document issued by Nice suggested that all, or at least most, central lines should be placed with ultrasound guidance.
In Birmingham, they have now extended this to using ultrasound to place Hickman lines in children with malignancy or intestinal failure.
Bennett continued: "Although I am mostly involved with children with liver disease, Hickman catheter placement in children can be difficult.
"To be honest, you really only have one good attempt at getting into the vein before you start causing a haematoma, making further access very difficult." The instruments are also used by anaesthetists to run transoesophageal echo during liver transplantation to monitor ventricular function and cardiac filling.
In addition, surgeons use the same machine with different probes to assess the liver itself - looking for tumours or for flow in the blood vessels around the time of liver transplantation - and hepatologists use a transcutaneous probe with the HDI 3500 to help with liver biopsy.
The flexibility of interchangeable probes and excellent image quality were the major reasons for the hospitals choosing Philips ultrasound systems.
Bennett said: "The systems are multi-tasking for a wide group of doctors dealing with a fairly complicated group of patients.
It was essential for us to have an instrument that was easily upgradeable and had a good range of probes and that was why we chose Philips Ultrasound, even above instruments that are particularly aimed at ultrasound of the veins and vessels."
