Verification of correct central venous catheter placement in the emergency department: comparison between ultrasonography and chest radiography

Zanobetti, Maurizio; Coppa, Alessandro; Bulletti, Federico; Piazza, S.; Nazerian, Peiman; Conti, Alberto; Innocenti, Francesca; Ponchietti, S.; Bigiarini, Sofia; Guzzo, Aurelia; Poggioni, Claudio; Taglia, Beatrice Del; Mariannini, Yuri; Pini, Riccardo

doi:10.1007/s11739-012-0885-7

Cited by 47 publications

(49 citation statements)

References 46 publications

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“…Vatansever [10] proposed fetal neuroimaging study that provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Anobetti [11] showed a high correlation between two modalities to identify possible malpositioning of a catheter resulting from cannulation of central veins, and its complications. The less time required to perform ultrasonography allows earlier use of the catheter for the administration of acute therapies that can be life-saving for the critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Brightness and Contrast Modification in Ultrasonography Images Using Edge Detection Results

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Brightness and Contrast Modification in Ultrasonography Images Using Edge Detection Results

et al. 2016

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“…This visualization of the echogenic agitated saline allowed for confirmation of correct CVC placement in an average of 10 minutes with 96% sensitivity. Zanobetti et al [14] used a more complex ultrasound protocol with multiple views and also observed correct CVC placement in an average of 5 minutes with 94% sensitivity. Although requiring more views, these studies are also promising for rapid confirmation of supra-diaphragmatic CVC.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, multiple studies have demonstrated that with a combination of ultrasound views and injectable materials, POCUS may be able to provide earlier and correct CVC positioning in the superior vena cava. [7,13,14] Vezzani et al [13] illustrated that the use of contrast enhanced, agitated saline could be used to confi rm placement of CVC. This visualization of the echogenic agitated saline allowed for confirmation of correct CVC placement in an average of 10 minutes with 96% sensitivity.…”

Section: Discussionmentioning

confidence: 99%

“…[4] Therefore, following placement, plain fi lm chest radiography (CXR) has been largely considered as standard to identify correct catheter tip location. [5] Point-of-care ultrasound (POCUS) has long been identifi ed as a reliable procedural guidance tool to reduce complications associated with CVC placement, [6,7] to identify post-procedure pneumothorax [7][8][9][10][11][12][13] and has most recently gained traction as a potential tool to reduce the potential delay of confirmatory post-procedure CXR during supra-diaphragmatic CVC placement. [7][8][9][10][11][12][13] However, these current ultrasound protocols to confirm supra-diaphragmatic CVC placement, even without a post-pneumothorax assessment can be complex and cumbersome for some users.…”

Section: Introductionmentioning

confidence: 99%

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Simplified point-of-care ultrasound protocol to confirm central venous catheter placement: A prospective study

Se¹,

Assaf²,

Lahham³

et al. 2017

World Journal of Emergency Medicine

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BACKGROUND:The current standard for confi rmation of correct supra-diaphragmatic central venous catheter (CVC) placement is with plain fi lm chest radiography (CXR). We hypothesized that a simple point-of-care ultrasound (POCUS) protocol could effectively confi rm placement and reduce time to confi rmation. METHODS:We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC. RESULTS:Seventy-eight patients were enrolled. POCUS had a sensitivity of 86.8% (95%CI 77.1%-93.5%) and specifi city of 100% (95%CI 15.8%-100.0%) for identifying correct central venous catheter placement. Median POCUS and CXR completion were 16 minutes (IQR 10-29) and 32 minutes (IQR 19-45), respectively. CONCLUSION:Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a confi rmatory CXR.

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“…Consistent with the result of current study they concluded that there is high correlation between aforementioned modalities in identifying possible malpositioning of the catheter. Furthermore, less time is required to perform ultrasonography comparing to CXR [21].…”

Section: Discussionmentioning

confidence: 99%

Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography

Anoosheh¹,

Abbasi²,

Mofìdi³

2017

ASS

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Introduction: Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings;accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Radiography and Sonography are two common procedures, which is used for localization of CVC. Due to volatile hemodynamic nature of patients, it is vital to follow CVC procedure and diagnose possible side effects and complications as soon as possible. Aim of current study is to assess efficacy, practicality and procedure time-curve between two aforementioned methods (Sonography Versus Radiography). After CV line preparation. Methodology: In current cross-sectional study we obtained 201 participants via convenient sampling method from Rasoul-E-Akram Hospital, Haftom-E-Tir Hospital and Firoozgar hospital. Participants were chosen from patients older than 18, who were admitted to ER or ICU in aforementioned hospitals and were candidate for CV line preparation. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Results: The average time of sonography procedure was estimated roughly 2.08 minutes, in which the maximum time was 5.5 minutes and the minimum time was 1.04 minutes. The standard deviation suggested that the sonography time for most of patients was about 2 minutes. Variance of sonography time among the above population was not reported. The data analysis showed that Chest XRay (CXR) time average for studied patients was about 40.82 minutes, in which the minimum time was 10 minutes and the maximum time was 150.15 minutes. The standard deviation of this variable suggested that variance level and CXR time difference among aforementioned patients were high (about 28.2). Bubble was found in the sonography of 199 cases and just two cases were excluded. According to these results, sensitivity of sonography was 99%, specificity was 100% and Kappa coefficient between sonography and radiography was 98%. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings.

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Verification of correct central venous catheter placement in the emergency department: comparison between ultrasonography and chest radiography

Cited by 47 publications

References 46 publications

Brightness and Contrast Modification in Ultrasonography Images Using Edge Detection Results

Brightness and Contrast Modification in Ultrasonography Images Using Edge Detection Results

Simplified point-of-care ultrasound protocol to confirm central venous catheter placement: A prospective study

Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography

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