Ultrasound Guided Confirmation of Tip of Peripherally Inserted Central Catheter in Neonates

Singh, Shipra; Venkatesh, HA; Swamy, Ravi; Nagesh, N Karthik

doi:10.1007/s13312-020-1968-6

Cited by 3 publications

(17 citation statements)

References 6 publications

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“…Ultrasound quality is highly operator-dependent, making it necessary that US providers are appropriately trained. The lack of implementation of US as a contemporary imaging modality within the NICU setting is often a result of the lack of availability of appropriately qualified US staff [ 45 ]. The level of training of US operators varied across all eight studies included in our review.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of ultrasound for localising peripherally inserted central catheter tips in infants in the neonatal intensive care unit: a systematic review and meta-analysis

et al. 2022

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Background Chest radiography after peripherally inserted central catheter insertion in infants is the reference standard method for verifying catheter tip position. The utilisation of ultrasound (US) for catheter placement confirmation in the neonatal and paediatric population has been the focus of many recent studies. Objective In this systematic review we investigated the diagnostic accuracy of US for peripherally inserted central catheter tip confirmation in infants in the neonatal intensive care unit (NICU) Materials and methods We conducted a systematic literature search of multiple databases. The study selection yielded eight articles, all of which had acceptable quality and homogeneity for inclusion in the meta-analysis. Sensitivity and specificity values were reported together with their respective 95% confidence intervals (CI). Results After synthesising the eligible studies, we found that US had a sensitivity of 95.2% (95% CI 91.9–97.4%) and specificity of 71.4% (95% CI 59.4–81.6%) for confirming catheter tip position. Conclusion Analyses indicated that US is an excellent imaging test for localising catheter tip position in the NICU when compared to radiography. Ultrasonography is a sensitive, specific and timely imaging modality for confirming PICC tip position. In cases where US is unable to locate malpositioned PICC tips, a chest or combined chest–abdominal radiograph should be performed.

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Section: Discussionmentioning

confidence: 99%

“…US is highly operator-dependent [ 47 ]. Adoption of bedside US in neonatal practice is gaining popularity; however, widespread implementation is hindered by the lack of unified guidelines and training for US use in neonatal critical care [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasound for localising peripherally inserted central catheter tips in infants in the neonatal intensive care unit: a systematic review and meta-analysis

et al. 2022

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“…A partir da análise de dados, sintetizados (Figura 3), foi possível identificar que os títulos revisados foram produzidos por pesquisadores residentes em três continentes: asiático (cinco de indianos 22,26,30,31,36 , três de iranianos 16,24,33 , dois de chineses 20,27 , um de libaneses 21 e um de taiwaneses 19 ); europeu (um de autores ingleses 15 e outro, de autores italianos 17 ) e americano (cinco de pesquisadores estadunidenses 25,28,29,32,34 , dois de brasileiros 18,23 e um de canadenses 35 ). Destes, dezenove foram capturados em inglês [15][16][17][19][20][21][22]24,36 , e dois em português 18,23 .…”

Section: Resultsunclassified

Cuidados do enfermeiro a recém-nascidos críticos no cateterismo epicutâneo auxiliado por ultrassonografia

Oliveira,

Silvino,

Vilar

et al. 2023

R. Pró-Uni.

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Resumo Introdução: Estudo de revisão, primeira fase de uma tese de doutorado, realizado com o objetivo de mapear evidências atuais que contemplem cuidados do enfermeiro a recém-nascidos críticos submetidos a cateterismo epicutâneo com ultrassonografia à beira do leito. Materiais e Métodos: Revisão de escopo, seguindo metodologia do Joanna Briggs Institute, com protocolo registrado na Open Science Framework. As buscas foram realizadas em cinco bases de dados e no Google Scholar, entre março e maio de 2022. A análise das citações dos estudos capturados foi um recurso utilizado para aumentar a amostra. Resultados: Os cuidados do enfermeiro que emergiram dos 22 estudos selecionados, publicados entre 2017 e 2022, em diversos países, foram apresentados por meio de quadro sinóptico, dividido em gestão do cuidado e cuidados diretos ao recém- nato nas fases de pré-inserção, inserção e manutenção e remoção do cateter. Discussão: A discussão narrativa realizada foi focada em recomendações atuais, derivadas da incorporação do ultrassom portátil ao processo estudado, tais como medidas suplementares para manutenção de barreira asséptica máxima, visualização de vasos mais aprofundados, escolha do cateter mais adequado ao vaso escolhido e confirmação da localização da ponta do cateter a partir de protocolos específicos, limitados. Considerações finais: O mapeamento realizado possibilitou a estratificação, baseada em evidências atuais, do cuidado do enfermeiro neonatal em cateterismo epicutâneo ecoassistido, e tem potencial tanto para contribuir no desenvolvimento de estudos futuros quanto para auxiliar nos cenários de prática, notadamente naqueles que visam incorporar o ultrassom em seus protocolos de enfermagem para estabelecimento de acessos venosos. Descritores: Cateterismo Venoso Central; Ultrassonografia de Intervenção; Recém-Nascido; Unidades de Terapia Intensiva Neonatal; Cuidados de Enfermagem

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“…Simultaneous blood gas analysis from another catheter confirmed to be either arterial or venous helps in direct comparison; however, such comparisons of blood gas measurements from two different sites may be equivocal in a critically ill infant with severe lung or cardiac disease. A pressure transducer can often discern the anatomy by The Journal of Vascular Access 23 (4) exhibiting waveforms in an arterial placement; however, the incompatibilities between the connectors might pose a practical challenge. Also, the small internal diameter of the catheter used in neonates, mechanical ventilation, and proximal vasospasm or thrombosis might dampen waveforms, making the distinction difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Alternative techniques such as near-infrared technology (NIR), real-time ultrasound (RTUS), and intracavitary electrocardiogram (ECG) can improve the accuracy of insertion and confirmation of tip position. [4][5][6] While using NIR and RTUS, the absence of pulsations and disappearance of the blood vessel on appropriate cannulation serve as methods to confirm the entry of an ECC into a vein. Both RTUS and intracavity ECG can assess the tip position of the ECC with far more accuracy 5,7 ; however, in a national survey of neonatal intensive care units (NICUs) in the United States done in 2013, 100% of NICUs still used radiography to confirm tip position.…”

Section: Discussionmentioning

confidence: 99%

When the course deviates from expected: Misplacement of an epicutaneo-caval catheter in a neonate

et al. 2021

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Central venous access, a common and essential component of the care of the critically ill neonate, is associated with complications such as infection, thrombosis, and bleeding. Unintentional arterial cannulation of a venous catheter is a rare but potentially dangerous complication. In the report, we describe the accidental cannulation of an artery with an epicutaneo-caval catheter in an extremely low birth weight infant. We discuss the physical and radiological findings that raise the suspicion of an arterial placement of a catheter, the diagnostic tools to confirm the misplacement, the potential complications, and strategies to prevent it.

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Ultrasound Guided Confirmation of Tip of Peripherally Inserted Central Catheter in Neonates

Cited by 3 publications

References 6 publications

Diagnostic accuracy of ultrasound for localising peripherally inserted central catheter tips in infants in the neonatal intensive care unit: a systematic review and meta-analysis

Diagnostic accuracy of ultrasound for localising peripherally inserted central catheter tips in infants in the neonatal intensive care unit: a systematic review and meta-analysis

Cuidados do enfermeiro a recém-nascidos críticos no cateterismo epicutâneo auxiliado por ultrassonografia

When the course deviates from expected: Misplacement of an epicutaneo-caval catheter in a neonate

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