The reliability of 2D and colour Doppler ultrasound in localising longline position

Kuschel, Carl A; Bach, Kitty P; Webster, Nicola J.; Page, Bernadette; Groves, Alan; Battin, Malcolm

doi:10.1111/j.1440-1754.2008.01333.x

Cited by 10 publications

(14 citation statements)

References 17 publications

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“…However, RT-US is a highly operator-dependent procedure, and it has been shown that the success rate in detecting the catheter's tip is directly proportional to the experience of the physicians performing this technique. 32 33 Our study is in line with the available evidence in this regard. Unfortunately, data about the optimal training and the learning curve are still lacking.…”

Section: Discussionsupporting

confidence: 91%

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates

et al. 2023

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Objective Epicutaneo-caval catheters (ECCs) are essential for the care of sick infants who require long-term medical and nutritional management. The aim of this study was to investigate the use of real-time ultrasound as an alternative to X-rays to reduce the incidence of primary malpositions during catheter insertion. Study Design Data on ECCs were retrospectively collected in a tertiary neonatal intensive care unit. Catheter were analyzed considering the tip location technique (standard chest–abdominal radiograph vs real-time ultrasound) Results A total of 248 ECCs were analyzed. Of these, 118 catheters had primary malposition (47.6%). The tip of 165 catheters was assessed using standard chest–abdominal X-rays and 107 (64.8%) were found to be in an inappropriate location. In the group of 83 catheters that were placed using real-time ultrasound for tip location, only 11 catheters (13.2%) had primary malposition. The rate of malposition among the two groups showed a statistically significant difference (p < 0.001). Hypothetically, 300 chest X-rays could have been saved if real-time ultrasound had been used to locate the tip, reducing radiation exposure to infants. Conclusion The use of a real-time ultrasound may be beneficial in reducing primary catheter malpositions compared with conventional radiography. In addition, secondary malpositions and catheter-related complications can be monitored over time. Key Points

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Section: Discussionsupporting

confidence: 91%

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates

et al. 2023

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“…Clinical studies on RT-US for tip location of ECCs show a direct correlation between the level of expertise of the clinician and the percentage of successful tip visualization. 45…”

Section: Methodsmentioning

confidence: 99%

“…Clinical studies on RT-US for tip location of ECCs show a direct correlation between the level of expertise of the clinician and the percentage of successful tip visualization. 45 In our experience, the minimum training requirements for ultrasound-based tip navigation and tip location of ECCs should include:…”

Section: Tip Location Protocolmentioning

confidence: 99%

Neo-ECHOTIP: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in neonates

et al. 2021

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Central venous access devices are often needed in neonates admitted to Neonatal Intensive Care Unit. The location of the tip of the central catheter is usually assessed by post-procedural X-ray. However, this strategy is inaccurate and time consuming. Recent guidelines strongly recommend intra-procedural methods of tip location, to increase the cost-effectiveness of the maneuver and to shorten the time between device placement and utilization. In this regard, real-time ultrasound represents the most promising tool for tip navigation and location in neonates. The aim of this paper is (a) to review all the evidence available about ultrasound-based tip navigation and tip location of central catheters in the neonatal population (b) to propose a novel protocol for tip navigation and location (Neo-ECHOTIP) based on such evidence.

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“…During the first stage, the titles and abstracts of the articles were screened, and non-relevant articles were excluded (71). Of papers that were deemed relevant to the study objectives, 19 met the inclusion criteria and were included in the analysis [1,11,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Among these articles, 15 are prospective observational studies [1,11,22,23,[26][27][28][30][31][32][33][34][35][36][37], two retrospective papers [24,29] and two randomized controlled trials [21,25].…”

Section: Resultsmentioning

confidence: 99%

The Role of Ultrasound in Epicutaneo-Caval Catheter Insertion in Neonates: Systematic Review, Meta-Analysis and Future Perspectives

D’Andrea,

Cascini,

Russo

et al. 2023

Diagnostics

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Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has been the subject of many recent studies. This systematic review investigates the accuracy of epicutaneo-caval catheter tip location by comparing ultrasound and conventional radiology. We performed a systematic literature search in multiple databases. The selection of studies yielded nineteen articles. The systematic review and meta-analysis were performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis). The analyses showed that ultrasound is a better imaging technique for epicutaneo-caval catheter tip location in the neonatal intensive care unit than conventional radiology. By improving operator training and selecting a standardized echography protocol, ultrasound could become the gold standard for visualizing the epicutaneo-caval catheter tip in the neonatal intensive care unit. This would have some important benefits: (1) increased accuracy in tip location (2); a more rapid use of the central venous access (3); and a significant reduction in radiation exposure.

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The reliability of 2D and colour Doppler ultrasound in localising longline position

Abstract: This technique is experience-dependent and complements rather than replaces the use of contrast radiography. However, some infants with an apparently acceptable longline position on contrast radiography have longlines located within the heart on echocardiography.

Cited by 10 publications

References 17 publications

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates

Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates

Neo-ECHOTIP: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in neonates

The Role of Ultrasound in Epicutaneo-Caval Catheter Insertion in Neonates: Systematic Review, Meta-Analysis and Future Perspectives

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