BACKGROUND: After the insertion of a central venous catheter, a chest radiograph is usually obtained to ensure correct positioning of the catheter tip. OBJECTIVE: To determine in a paediatric population whether B-mode and colour Doppler sonography after central venous access is useful to evaluate catheter position, thus obviating the need for a postprocedural radiograph. MATERIALS AND METHODS: A prospective study of 107 consecutive central venous access procedures placed in a paediatric intensive care unit was performed. At the end of the procedure, B-mode and colour Doppler sonography were used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. RESULTS: In 96 patients postprocedural B-mode and colour Doppler sonography showed colour Doppler signals within the vena cava. Among the 11 patients predicted to have a potential complication, there was one pneumothorax and ten malpositions. Chest radiography showed a total of 13 complications-1 pneumothorax and 12 malpositions. The concordance between colour Doppler sonography and chest radiography was 98.1% in the detection of catheter position; sonography had a sensitivity of 84.6% and a specificity of 100%. CONCLUSIONS: The close concordance between B-mode and colour Doppler sonography and chest radiography justifies the more frequent use of sonography to evaluate catheter position because ionizing radiation is eliminated. Chest radiography may then be performed only when there is suspected inappropriate catheter tip position after sonography.
BACKGROUND: After the insertion of a central venous catheter, a chest radiograph is usually obtained to ensure correct positioning of the catheter tip. OBJECTIVE: To determine in a paediatric population whether B-mode and colour Doppler sonography after central venous access is useful to evaluate catheter position, thus obviating the need for a postprocedural radiograph. MATERIALS AND METHODS: A prospective study of 107 consecutive central venous access procedures placed in a paediatric intensive care unit was performed. At the end of the procedure, B-mode and colour Doppler sonography were used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. RESULTS: In 96 patients postprocedural B-mode and colour Doppler sonography showed colour Doppler signals within the vena cava. Among the 11 patients predicted to have a potential complication, there was one pneumothorax and ten malpositions. Chest radiography showed a total of 13 complications-1 pneumothorax and 12 malpositions. The concordance between colour Doppler sonography and chest radiography was 98.1% in the detection of catheter position; sonography had a sensitivity of 84.6% and a specificity of 100%. CONCLUSIONS: The close concordance between B-mode and colour Doppler sonography and chest radiography justifies the more frequent use of sonography to evaluate catheter position because ionizing radiation is eliminated. Chest radiography may then be performed only when there is suspected inappropriate catheter tip position after sonography.
Authors: E S Wiener; P McGuire; C J Stolar; R H Rich; V C Albo; A R Ablin; D L Betcher; A L Sitarz; J D Buckley; M D Krailo Journal: J Pediatr Surg Date: 1992-02 Impact factor: 2.545
Authors: Christoph F Dietrich; Rudolf Horn; Susanne Morf; Liliana Chiorean; Yi Dong; Xin-Wu Cui; Nathan S S Atkinson; Christian Jenssen Journal: J Thorac Dis Date: 2016-09 Impact factor: 2.895
Authors: Rogerio da Hora Passos; Michel Ribeiro; Julio Neves; Joao Gabriel Rosa Ramos; Adelmo Vinicius Lima Oliveira; Zilma Barreto; Rosseane Ferreira; Conrado Gomes; Paulo Benigno Pena Batista; Jean Jacques Rouby Journal: Kidney Int Rep Date: 2017-04-07
Authors: Jasper M Smit; Reinder Raadsen; Michiel J Blans; Manfred Petjak; Peter M Van de Ven; Pieter R Tuinman Journal: Crit Care Date: 2018-03-13 Impact factor: 9.097
Authors: Yong In Kim; Ji Ho Ryu; Mun Ki Min; Maeng Real Park; Soon Chang Park; Seok Ran Yeom; Sang Kyoon Han; Sung Wook Park; Seong Hwa Lee Journal: Clin Exp Emerg Med Date: 2018-06-29