title: Validity and reliability of an ultrasound device for detecting carotid emboli.
abstract: Cardioembolic mechanisms cause 15 to 20% of all strokes and may account for the high incidence of neurological dysfunction associated with cardiopulmonary bypass.  Accurate identification of high-risk subjects and/or surgical techniques would allow more effective testing and implementation of preventive or therapeutic measures to help reduce morbidity and mortality.  This article reports on validity and reliability testing of a new emboli detection device that allows continuous monitoring of the common carotid artery.  The instrument appears to be capable of detecting accurately particles of 193 mu or less in diameter and is highly reliable both within and between observers.  In preliminary clinical use, the instrument also detected embolic signals in all patients monitored during cardiopulmonary bypass, while none were detected in healthy control subjects.  These results establish the validity and reliability of a new emboli detection device and suggest its potential application to emboli detection monitoring during cardiopulmonary bypass.
authors.affiliation: Departments of Neurology and Anesthesiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC  27103.
authors.forename: D A
authors.initials: DA
authors.lastname: Stump
authors.forename: C S
authors.initials: CS
authors.lastname: Stein
authors.forename: C H
authors.initials: CH
authors.lastname: Tegeler
authors.forename: L P
authors.initials: LP
authors.lastname: Hitchings
authors.forename: R
authors.initials: R
authors.lastname: Hager
authors.forename: M
authors.initials: M
authors.lastname: Eicke
authors.forename: G L
authors.initials: GL
authors.lastname: Burke
mesh_terms: D002315:Cardiopulmonary Bypass; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D004617:Embolism / Q000000981:diagnostic imaging*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D008863:Microspheres; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D015588:Observer Variation; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods