University Medical Center / 2017

Administration of Lumason for contrast Echocardiography

Information:

Lumason® is an ultrasound contrast agent indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.Lumason is manufactured under an FDA approved manufacturing process.

Equipment: 1 Lumason kit contains

  • 1 vial of Lumason lyophilized powder for injectable suspension, 60.7 mg sulfur hexafluoride/ 25mg lipid type A
  • 1 prefilled syringe containing 5ml sodium chloride 0.9% injection
  • 1 mini spike

Policy:

  1. Lumason is indicated for use in patients with suboptimal Echocardiograms to opacify the left ventricle and to improve the delineation of the left ventricular endocardial borders.
  1. Lumason enhanced echocardiography is performed during an echocardiogram and/or stress echocardiogram on patients that meet the following criteria
  • Any patient that specifically has an echocardiogram ordered to evaluate LV function and 2 or more segments cannot be visualized
  • Any patient with peripheral vascular disease, which is technically difficult to image.
  • All patients receiving exercise or pharmacologic stress echocardiogram studies.
  1. Injection of Lumason will be done by an RN, MD or sonographer.
  2. Store Lumasonbefore and after reconstitution at temperatures between (59- 86 F).

Contraindications:

- History of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components (see

WARNINGS)

-Do not administer Lumasonby intra-arterial injection.

-Do not administer Lumason to women who are or may be pregnant or nursing

-Do not administer Lumason to patients under 18 years old

Warnings:

Serious cardiopulmonary reactions, including fatalities, have occurred during or following perflutren containing micro sphere administration.

  • Assess all patients for the presence of any condition that precludes Lumason administration (see contraindications).
  • Always have resuscitation equipment and trained personnel readily available.
  • When administering Lumason to patients with cardiac shunts, microspheres can bypass filtering by the lung andenter the arterial circulation. Assess patients with shuntsfor embolic phenomena following Lumason administration. Lumason is for intravenous and/or intravesical administration; do not administer Lumason by intra-arterial injection.

Administration of Lumason

Procedure:

  1. Inform the patient regarding the indications for the use of Lumason
  2. The sonographer, MD/DO, RN must screen the patient for contraindications to the use of Lumason
  3. Lumason Preparation:
  1. Connect the plunger rod to the prefilled syringebarrel by screwing it clockwise into the syringe.
  2. Open the Mini-Spike blister and remove thesyringe tip cap.
  3. Open the Mini-Spike green cap and connectthe syringe to the Mini-Spike by screwing it inclockwise.
  4. Remove the flip cap plastic protective cap from the vial, removethe Mini-Spike spike protection and position the spike in thecenter of the rubber stopper of the vial. Press firmly inward untilthe spike is fully inserted in the stopper
  5. Empty the content of the syringe into the vial by pushing on theplunger rod.
  6. Shake vigorously for 20 seconds, mixing all the contents in thevial. A homogeneous white milky liquid indicatesformation of sulfur hexafluoride lipid microspheres.
  7. Invert the system and slowly withdraw 2 mL of suspension into the syringe.
  8. Unscrew the syringe from the Mini-Spike.

Immediately connect the syringe to the dose administration line and administer as directed under Administration section below.

Lumason Administration:

• Administer Lumason as an intravenous bolus injection.

• The milky white Lumason suspension should be used immediately after reconstitution. If the suspension is not used immediately after reconstitution, the microspheres should be resuspended by a few seconds of hand agitation before the suspension is withdrawn into the syringe. Reconstituted suspension within a vial may be used for up to 3 hours from the time of its reconstitution, after the microspheres have been resuspended by hand agitation prior to withdrawal of the suspension into the syringe. Maintain the vial containing the reconstituted suspension at room temperature.

• Lumason is for single use only. Unused portions of the reconstituted suspension must be discarded after one use in accordance with regulations dealing with the disposal of such materials. Syringe andother materials used should also be properly disposed of after single use.

Dosing and Administration:

  • Lumason should be administered in .5cc to 2cc doses to provide complete left ventricular opacification. The injection rate should not exceed 1 ml per second.
  • Lumason injection should be followed by a .5 cc to 3cc saline flush.

Documentation:

  • Lumason indication and dosing will be recorded on technical portion of the report by the sonographer or nurse, it will also be ordered and signed off in EPIC and documented in patient MAR.

Created: November2015

Revised:January 2017

Medical Director

MD Melissa J. Tracy

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