OBJECTIVES: The purpose of this study is to describe a novel method to visualize the position of central venous catheters, which is safe, expeditious, and less expensive than the routine postprocedural chest radiograph. DESIGN: Retrospective comparative study. SETTING: Dialysis Center of the Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. PATIENTS: Two hundred and two adult patients undergoing central venous catheter placement for dialysis, plasmapheresis, or administration of medication and solutions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data of 202 adult patients with 219 central venous catheterizations were retrospectively analyzed. Each catheter insertion was followed by an agitated saline bubble-enhanced transthoracic echocardiography, which was used to localize the tip of the catheter. The position of catheter was then controlled by chest radiograph in all cases. During the 13-month study period, two catheter malpositions occurred. Both were identified by agitated saline bubble-enhanced transthoracic echocardiography and confirmed by chest radiograph. The mean time between catheter insertion and chest radiograph control (28.3 min) was clearly longer than agitated saline bubble-enhanced transthoracic echocardiography (3.2 min) (p < 0.001). The total costs of the procedure were reduced by 86.7-95.0%. Specific complications related to the procedure were not observed. CONCLUSIONS: The results revealed that the accuracy of agitated saline bubble-enhanced transthoracic echocardiography is equivalent to the chest radiograph. It offers a safe, cost-effective, expeditious alternative to routine chest radiograph for position controls of central venous catheters.
OBJECTIVES: The purpose of this study is to describe a novel method to visualize the position of central venous catheters, which is safe, expeditious, and less expensive than the routine postprocedural chest radiograph. DESIGN: Retrospective comparative study. SETTING: Dialysis Center of the Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. PATIENTS: Two hundred and two adult patients undergoing central venous catheter placement for dialysis, plasmapheresis, or administration of medication and solutions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data of 202 adult patients with 219 central venous catheterizations were retrospectively analyzed. Each catheter insertion was followed by an agitated saline bubble-enhanced transthoracic echocardiography, which was used to localize the tip of the catheter. The position of catheter was then controlled by chest radiograph in all cases. During the 13-month study period, two catheter malpositions occurred. Both were identified by agitated saline bubble-enhanced transthoracic echocardiography and confirmed by chest radiograph. The mean time between catheter insertion and chest radiograph control (28.3 min) was clearly longer than agitated saline bubble-enhanced transthoracic echocardiography (3.2 min) (p < 0.001). The total costs of the procedure were reduced by 86.7-95.0%. Specific complications related to the procedure were not observed. CONCLUSIONS: The results revealed that the accuracy of agitated saline bubble-enhanced transthoracic echocardiography is equivalent to the chest radiograph. It offers a safe, cost-effective, expeditious alternative to routine chest radiograph for position controls of central venous catheters.
Authors: Michael R Acord; Anne Marie Cahill; Rachelle Durand; Dean Y Huang; Sphoorti Shellikeri; Seth Vatsky; Abhay Srinivasan Journal: Pediatr Radiol Date: 2021-05-12
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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