Comparison between ultrasonography and X-ray as evaluation methods of central venous catheter positioning and their complications in pediatrics.

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.

journal_name

Pediatr Surg Int

authors

Oliveira L,Pilz L,Tognolo CM,Bischoff C,Becker KA,Oliveira GG,Neves PJF,Fachin CG,Agulham MA,Dias AIBS

doi

10.1007/s00383-020-04642-y

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

563-568

issue

5

eissn

0179-0358

issn

1437-9813

pii

10.1007/s00383-020-04642-y

journal_volume

36

pub_type

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