Ultrasonic Examination

Maury, Éric; Guglielminotti, Jean; Alzieu, Marc; Guidet, Bertrand; Offenstadt, G.

doi:10.1164/ajrccm.164.3.2009042

Cited by 134 publications

(44 citation statements)

References 18 publications

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“…Some of these studies described ultrasonography as an accurate method for identifying catheter location and avoiding life-threatening complications, such as pneumothorax (12-15, 17-19). Maury and colleagues reported a high success rate of ultrasonic evaluation in detecting aberrant catheter location and pneumothorax (14). Vezzani and colleagues compared chest radiography with a combination of B-mode ultrasonography and CEUS.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

et al. 2016

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BackgroundChest radiography after central venous catheter (CVC) insertion is the main method of verifying the catheter location. Despite the widespread use of radiography for detecting catheter position, x-ray may not always be readily available, especially in the operating room.ObjectivesWe aimed to compare contrast-enhanced ultrasonography (CEUS) and chest radiography for detecting the correct location of CVCs.MethodsOne hundred sixteen consecutive patients with indications for CVC before cardiac surgery were enrolled in this observational study. After catheter insertion, CEUS was performed. Portable radiography was obtained postoperatively in the intensive care unit. Sensitivity, specificity, and predictive values were determined by comparing the ultrasonography results with radiographic findings as a reference standard.ResultsChest radiography revealed 16 CVC misplacements: two cases of intravascular and 14 cases of right atrium (RA) misplacement. CEUS detected 11 true catheter malpositionings in the RA, while it could not recognize seven catheter placements correctly. CEUS showed two false RA misplacements and five falsely correct CVC positions. A sensitivity of 98% and specificity of 69% were achieved for CEUS in detecting CVC misplacements. Positive and negative predictive values were 95% and 85%, respectively. The interrater agreement (kappa) between CEUS and radiography was 0.72 (P < 0.001).ConclusionsDespite close concordance between ultrasonography and chest radiography, CEUS is not a suitable alternative for standard chest radiography in detecting CVC location; however, considering its high sensitivity and acceptable specificity in our study, its usefulness as a triage method for detecting CVC location on a real-time basis in the operating room cannot be ignored.

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Section: Discussionmentioning

confidence: 99%

“…Post-procedure chest radiography is the main method of verifying catheter location. Despite the widespread use of this method, it is time-consuming and it exposes patients to high levels of radiation (12-14). In addition, the feasibility of immediate post-procedure radiography is controversial.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

et al. 2016

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“…In contrast, the time required for ultrasound examination was much shorter (6.8 ± 3.5 min) [8]. A prior evaluation in our institution showed that the median processing time was 20 min and ranged from 5 min to 25 min.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that ultrasound can detect the absence of complications and the correct positioning of the catheter and can reduce the processing time of the audit report on chest radiographs [8,22]. The standard deviation of the processing time varies between 5 min and 25 min.…”

Section: Methodsmentioning

confidence: 99%

“…However, the only temporal parameter recorded was the time between penetration of the skin and aspiration of venous blood into the syringe; thus, the time required for the entire procedure has never been evaluated. Ultrasonic diagnosis of catheter misplacement and pneumothorax related to central venous catheterization was reported to be a rapid and accurate method that can be easily performed by ICU physicians [8]. …”

Section: Introductionmentioning

confidence: 99%

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Guidance and examination by ultrasound versus landmark and radiographic method for placement of subclavian central venous catheters: study protocol for a randomized controlled trial

Parratte

Pereira

Grimaldi

et al. 2014

Trials

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BackgroundCentral venous catheters play an important role in patient care. Real-time ultrasound-guided subclavian central venous (SCV) cannulation may reduce the incidence of complications and the time between skin penetration and the aspiration of venous blood into the syringe. Ultrasonic diagnosis of catheter misplacement and pneumothorax related to central venous catheterization is rapid and accurate. It is unclear, however, whether ultrasound real-time guidance and examination can reduce procedure times and complication rates when compared with landmark guidance and radiographic examination for SCV catheterization.Methods/DesignThe Subclavian Central Venous Catheters Guidance and Examination by UltraSound (SUBGEUS) study is an investigator-initiated single center, randomized, controlled two-arm trial. Three hundred patients undergoing SCV catheter placement will be randomized to ultrasound real-time guidance and examination or landmark guidance and radiographic examination. The primary outcome is the time between the beginning of the procedure and control of the catheter. Secondary outcomes include the times required for the six components of the total procedure, the occurrence of complications (pneumothorax, hemothorax, or misplacement), failure of the technique and occurrence of central venous catheter infections.DiscussionThe SUBGEUS trial is the first randomized controlled study to investigate whether ultrasound real-time guidance and examination for SCV catheter placement reduces all procedure times and the rate of complications.Trial registrationClinicalTrials.gov Identifier: NCT01888094

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Rapid Development of Resident-Led Procedural Response Teams to Support Patient Care During the Coronavirus Disease 2019 Epidemic

2020

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Surgeons are no strangers to mass casualty incidents. Although the coronavirus disease 2019 (COVID-19) epidemic may not involve many trips to the operating room, the lessons learned in organizational management of prior natural disasters, mass shootings, and transportation incidents are valuable. At our institution, more than a quarter of patients who initially present with COVID-19 have been intubated, requiring multiple, time-consuming bedside procedures for hemodynamic monitoring and central venous access. As the hospital architecture has changed to suit the demands of the coronavirus pandemic, its workforce has also needed to evolve.In response, the surgical residency has created a special team, the surgical workforce activation team (SWAT), to help offload procedural work from the other emergency medicine, critical care, and medicine departments. The mission of the SWAT is to build and deploy a specialized team of clinicians with the skill set to efficiently perform bedside procedures in an effort to support our colleagues, reduce health care personnel exposure, preserve personal protective equipment, and provide quality care to patients during the COVID-19 pandemic. We have performed common, time-consuming procedures, including setting up central catheters, arterial catheters, and dialysis catheters, thereby alleviating the workflow of intensive care unit (ICU) teams.

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Ultrasonic Examination

Cited by 134 publications

References 18 publications

Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

Guidance and examination by ultrasound versus landmark and radiographic method for placement of subclavian central venous catheters: study protocol for a randomized controlled trial

Rapid Development of Resident-Led Procedural Response Teams to Support Patient Care During the Coronavirus Disease 2019 Epidemic

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