Comparison between ultrasonography and X-ray as evaluation methods of central venous catheter positioning and their complications in pediatrics
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Mar 2020 · 1 min read
In brief
In brief
Prospective study comparing ultrasound versus chest X-ray for confirming central venous catheter placement in 21 pediatric patients. Ultrasound showed 100% specificity but only 33% sensitivity using four-chamber cardiac view with saline flush, making it useful for ruling in correct placement but requiring radiographic confirmation when negative.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study evaluates the capacity of ultrasonography as a diagnostic method to confirm the proper positioning of central venous catheter (CVC) when compared to the current gold standard, chest radiography (CR).
Methods
A prospective study was performed including children from 0 to 14 incomplete years, who underwent CVC placement between March and May 2018 at a teaching hospital in Brazil. A four-chamber view of the heart was performed with ultrasound during a rapid injection of saline solution to identify hyperechoic images and confirm the central position of the catheter. After that, a CR was performed. The diagnostic quality of ultrasound was evaluated based on accuracy, sensitivity, specificity, positive and negative predictive values.
Results
A total of 21 patients were analyzed. The mean age was 3.95 ± 4.01 years. The preferred puncture site was the right internal jugular vein (71.4%). Ultrasound accuracy to detect CVC positioning was 81%. Sensitivity, specificity and positive and negative predictive values were 33%, 100%, 100% and 79%, respectively.
Conclusion
Ultrasound is a reliable method for detection of CVC positioning. Even so, with the four-chamber cardiac view, this method is unable to identify catheters inside heart chambers, therefore, needing to confirm the positioning with CR.