Contrast enhanced ultrasound vs chest X-ray to determine correct central venous catheter position

2014 ◽  
Vol 32 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Francesca Cortellaro ◽  
Luca Mellace ◽  
Stefano Paglia ◽  
Giorgio Costantino ◽  
Sara Sher ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Contrast Enhanced Ultrasound ◽  
Central Venous ◽  
Catheter Position ◽  
X Ray ◽  
Contrast Enhanced ◽  
Chest X Ray

Contrast enhanced ultrasound as a new tool to estimate the performance of midline catheters in the single patient

2021 ◽  
pp. 112972982110346
Author(s):  
Antonio Gidaro ◽  
Francesco Casella ◽  
Francesca Lugli ◽  
Chiara Cogliati ◽  
Maria Calloni ◽  
...  
Keyword(s):  
Contrast Enhanced Ultrasound ◽  
Single Patient ◽  
Central Venous ◽  
X Ray ◽  
Chamber View ◽  
Contrast Enhanced ◽  
Chest X Ray ◽  
Vein Diameter ◽  
Tip Position ◽  
Echocardiographic Images

Background: Contrast enhanced ultrasound (CEUS) through MicroBubbles Time (MBT) (time from infusion of saline with addition of micro-bubbles of air to visualization of first bubbles in right atrium (RA), visualized by subxiphoid or apical echocardiography) is an alternative to Intracavitary ECG and chest X-ray in evaluation of tip location in central venous catheters. Objective: To evaluate feasibility and variability of CEUS in peripheral catheters (Midline-MC) in a cohort of patients and in a subgroup where tip location was also performed through chest X-ray. Secondary outcomes were verifying the correlation between MBT and distance between tip of MC and RA (anthropometric and radiological measures), body mass index (BMI), vein diameter at point of insertion. Methods: Patients with insertion of MC were enrolled in this prospective cohort. After catheter insertion, CEUS was performed recording MBT. Results: One hundred thirty-two MCs were inserted, 45 performed Chest X-ray. MBT wasn’t feasible in 7 (5%) because of low quality echocardiographic images. Subcostal view was available in 114 patients (91.2%), while 11 patients (8.8%) were examined through apical four-chamber view. Mean MBT in the whole population was 2.3 ± 0.8 s. Significant correlation between anthropometric and radiological measures, BMI and MBT was found. 32.8% of MC had a MBT ⩽2 s. Conclusions: CEUS could be useful to estimate tip position. Our study showed how 2 s is not a suitable cutoff to confirm central catheter’s tip.

scholarly journals Protocol for DRAUP: a deimplementation programme to decrease routine chest radiographs after central venous catheter insertion

2021 ◽  
Vol 10 (4) ◽  
pp. e001222
Author(s):  
Enyo A Ablordeppey ◽  
Byron Powell ◽  
Virginia McKay ◽  
Shannon Keating ◽  
Aimee James ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Acute Care ◽  
Imaging Modality ◽  
Phase 1 ◽  
Venous Catheter ◽  
Point Of Care Ultrasound ◽  
Central Venous ◽  
X Ray ◽  
Chest X Ray ◽  
Routine Chest

IntroductionAvoiding low value medical practices is an important focus in current healthcare utilisation. Despite advantages of point-of-care ultrasound (POCUS) over chest X-ray including improved workflow and timeliness of results, POCUS-guided central venous catheter (CVC) position confirmation has slow rate of adoption. This demonstrates a gap that is ripe for the development of an intervention.MethodsThe intervention is a deimplementation programme called DRAUP (deimplementation of routine chest radiographs after adoption of ultrasound-guided insertion and confirmation of central venous catheter protocol) that will be created to address one unnecessary imaging modality in the acute care environment. We propose a three-phase approach to changing low-value practices. In phase 1, we will be guided by the Consolidated Framework for Implementation Research framework to explore barriers and facilitators of POCUS for CVC confirmation in a single centre, large tertiary, academic hospital via focus groups. The qualitative methods will inform the development and adaptation of strategies that address identified determinants of change. In phase 2, the multifaceted strategies will be conceptualised using Morgan’s framework for understanding and reducing medical overuse. In phase 3, we will locally implement these strategies and assess them using Proctor’s outcomes (adoption, deadoption, fidelity and penetration) in an observational study to demonstrate proof of concept, gaining valuable insights on the programme. Secondary outcomes will include POCUS-guided CVC confirmation efficacy measured by time and effectiveness measured by sensitivity and specificity of POCUS confirmation after CVC insertion.With limited data available to inform interventions that use concurrent implementation and deimplementation strategies to substitute chest X-ray for POCUS using the DRAUP programme, we propose that this primary implementation and secondary effectiveness pilot study will provide novel data that will expand the knowledge of implementation approaches to replacing low value or unnecessary care in acute care environments.Ethics and disseminationApproval of the study by the Human Research Protection Office has been obtained. This work will be disseminated by publication of peer-reviewed manuscripts, presentation in abstract form at scientific meetings and data sharing with other investigators through academically established means.Trial registration numberClinicalTrials.gov Identifier, NCT04324762, registered on 27 March 2020.

scholarly journals Ultrasound to Detect Central Venous Catheter Placement Associated Complications

2020 ◽  
Vol 132 (4) ◽  
pp. 781-794 ◽  
Author(s):  
Jasper M. Smit ◽  
Mark E. Haaksma ◽  
Endry H. T. Lim ◽  
Thei S. Steenvoorden ◽  
Michiel J. Blans ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Diagnostic Accuracy ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Reference Standard ◽  
Central Venous ◽  
Central Venous Catheter Placement ◽  
X Ray ◽  
Venous Catheterization ◽  
Chest X Ray

Abstract Background Mechanical complications arising after central venous catheter placement are mostly malposition or pneumothorax. To date, to confirm correct position and detect pneumothorax, chest x-ray film has been the reference standard, while ultrasound might be an accurate alternative. The aim of this study was to evaluate diagnostic accuracy of ultrasound to detect central venous catheter malposition and pneumothorax. Methods This was a prospective, multicenter, diagnostic accuracy study conducted at the intensive care unit and postanesthesia care unit. Adult patients who underwent central venous catheterization of the internal jugular vein or subclavian vein were included. Index test consisted of venous, cardiac, and lung ultrasound. Standard reference test was chest x-ray film. Primary outcome was diagnostic accuracy of ultrasound to detect malposition and pneumothorax; for malposition, sensitivity, specificity, and other accuracy parameters were estimated. For pneumothorax, because chest x-ray film is an inaccurate reference standard to diagnose it, agreement and Cohen’s κ-coefficient were determined. Secondary outcomes were accuracy of ultrasound to detect clinically relevant complications and feasibility of ultrasound. Results In total, 758 central venous catheterizations were included. Malposition occurred in 23 (3.3%) out of 688 cases included in the analysis. Ultrasound sensitivity was 0.70 (95% CI, 0.49 to 0.86) and specificity 0.99 (95% CI, 0.98 to 1.00). Pneumothorax occurred in 5 (0.7%) to 11 (1.5%) out of 756 cases according to chest x-ray film and ultrasound, respectively. In 748 out of 756 cases (98.9%), there was agreement between ultrasound and chest x-ray film with a Cohen’s κ-coefficient of 0.50 (95% CI, 0.19 to 0.80). Conclusions This multicenter study shows that the complication rate of central venous catheterization is low and that ultrasound produces a moderate sensitivity and high specificity to detect malposition. There is moderate agreement with chest x-ray film for pneumothorax. In conclusion, ultrasound is an accurate diagnostic modality to detect malposition and pneumothorax. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

A rare case of central venous catheter malpositioning in polytraumatic patient not recognized by chest x-ray

2012 ◽  
Vol 14 (1) ◽  
pp. 97-98 ◽  
Author(s):  
Simonetta Nataloni ◽  
Andrea Carsetti ◽  
Vincenzo Gabbanelli ◽  
Abele Donati ◽  
Erica Adrario ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Rare Case ◽  
Venous Catheter ◽  
Central Venous ◽  
X Ray ◽  
Chest X Ray

scholarly journals Is chest X-ray necessary after central venous catheter insertion?

Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P129 ◽  
Author(s):  
MS Vallecoccia ◽  
F Cavallaro ◽  
M Biancone ◽  
D Settanni ◽  
C Marano ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
X Ray ◽  
Chest X Ray

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

2016 ◽  
Vol 6 (5) ◽  
Author(s):  
Hamid Kamalipour ◽  
Sedigheh Ahmadi ◽  
Karmella Kamali ◽  
Alireza Moaref ◽  
Masih Shafa ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Good Alternative ◽  
Central Venous ◽  
X Ray ◽  
Chest X Ray
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