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Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography

Received: 25 September 2017    Accepted: 11 November 2017    Published: 22 December 2017
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Abstract

Introduction: Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Radiography and Sonography are two common procedures, which is used for localization of CVC. Due to volatile hemodynamic nature of patients, it is vital to follow CVC procedure and diagnose possible side effects and complications as soon as possible. Aim of current study is to assess efficacy, practicality and procedure time-curve between two aforementioned methods (Sonography Versus Radiography). After CV line preparation. Methodology: In current cross-sectional study we obtained 201 participants via convenient sampling method from Rasoul-E-Akram Hospital, Haftom-E-Tir Hospital and Firoozgar hospital. Participants were chosen from patients older than 18, who were admitted to ER or ICU in aforementioned hospitals and were candidate for CV line preparation. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Results: The average time of sonography procedure was estimated roughly 2.08 minutes, in which the maximum time was 5.5 minutes and the minimum time was 1.04 minutes. The standard deviation suggested that the sonography time for most of patients was about 2 minutes. Variance of sonography time among the above population was not reported. The data analysis showed that Chest X-Ray (CXR) time average for studied patients was about 40.82 minutes, in which the minimum time was 10 minutes and the maximum time was 150.15 minutes. The standard deviation of this variable suggested that variance level and CXR time difference among aforementioned patients were high (about 28.2). Bubble was found in the sonography of 199 cases and just two cases were excluded. According to these results, sensitivity of sonography was 99%, specificity was 100% and Kappa coefficient between sonography and radiography was 98%. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings.

Published in Advances in Surgical Sciences (Volume 5, Issue 6)
DOI 10.11648/j.ass.20170506.11
Page(s) 69-72
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Catheterization, Central Venous, Interventional, Radiography, Ultrasonography

References
[1] Sznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S. Central vein catheterization: Failure and complication rates by three percutaneous approaches. Arch Intern Med. 1986;146:259–61. [PubMed]
[2] Defalque RJ. Percutaneous catheterization of the internal jugular vein. Anesth Analg. 1974;53:116–21.[PubMed]
[3] Goldfarb G, Lebrec D. Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: An experience based on 1,000 attempts. Anesthesiology. 1982;56:321–3. [PubMed]
[4] Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavianvein catheterization. N Engl J Med. 1994;331:1735–8. [PubMed]
[5] Ruesch S, Walder B, Tramer MR. Complications of central venous catheters: internal jugular versus subclavian access--a systematic review. Crit Care Med. 2002;30(2):454–60. [PubMed]
[6] Aminnejad R, Razavi SS, Mohajerani SA, Mahdavi SA. Subclavian Vein Cannulation Success Rate in Neonates and Children. Anesth Pain Med. 2015;5(3):24156. doi: 10.5812/aapm.24156v2.[PMC free article] [PubMed] [Cross Ref]
[7] Moeinipour AA, Amouzeshi A, Joudi M, Fathi M, Jahanbakhsh S, Hafez S, et al. A rare central venous catheter malposition: a case report. Anesth Pain Med. 2014;4(1):16049. doi: 10.5812/aapm.16049.[PMC free article] [PubMed] [Cross Ref]
[8] Lie J, Yadagiri M, Aspinall C. Letter to editor on a rare central venous catheter malposition. Anesth Pain Med. 2014;4(4):20019. doi: 10.5812/aapm.20019. [PMC free article] [PubMed] [Cross Ref]
[9] Fathi M, Izanloo A, Jahanbakhsh S, Taghavi Gilani M, Majidzadeh A, Sabri Benhang A, et al. Central Venous Cannulation of the Internal Jugular Vein Using Ultrasound-Guided and Anatomical Landmark Techniques. Anesth Pain Med. In Press;In Press:35803. [PMC free article] [PubMed]
[10] Lentz RJ, Sandler KL, Miller AN. Cannulation of the Internal Thoracic Artery with a Central Venous Catheter. Am J Respir Crit Care Med. 2016;193(5):9–11. doi: 10.1164/rccm.201509-1748IM. [PubMed] [Cross Ref]
[11] Shah PN, Kane D, Appukutty J. Depth of central venous catheterization by intracardiac electrocardiogram in adults. Anesth Pain Med. 2013;2(3):111–4. doi: 10.5812/aapm.7557.[PMC free article] [PubMed] [Cross Ref]
[12] Orme RM, McSwiney MM, Chamberlain-Webber RF. Fatal cardiac tamponade as a result of a peripherally inserted central venous catheter: a case report and review of the literature. Br J Anaesth. 2007;99(3):384–8. doi: 10.1093/bja/aem181. [PubMed] [Cross Ref]
[13] Collier PE, Blocker SH, Graff DM, Doyle P. Cardiac tamponade from central venous catheters. Am J Surg. 1998;176(2):212–4. [PubMed]
[14] Xirouchaki N, Magkanas E, Vaporidi K, et al. Lung ultrasound in critically ill patients: comparison with bedside chest radiography. Intensive Care Med. 2011;37:14,88-93.
[15] Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117-25.
[16] Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G. (2001). Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion?. Available: https://www.ncbi.nlm.nih.gov/pubmed/11500340. Last accessed October-2017.
[17] Vezzani A, Brusasco C, Palermo S, Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax: an alternative to chest radiography. Crit Care Med. 2010 Feb;38(2):533-8.
[18] Zanobetti M, Poggioni C, Pini R. (2011). Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Available: https://www.ncbi.nlm.nih.gov/pubmed/20947649. Last accessed October-2017.
[19] Duran-Gehring PE, Guirgis FW, McKee KC, The bubble study: ultrasound confirmation of central venous catheter placement. Am J Emerg Med. 2015 Mar;33(3):315-9.
[20] Matsushima K, Frankel HL. (2010). Bedside ultrasound can safely eliminate the need for chest radiographs after central venous catheter placement: CVC sono in the surgical ICU (SICU). Available: https://www.ncbi.nlm.nih.gov/pubmed/20599208. Last accessed October-2017.
[21] Zanobetti M, Coppa A, Bulletti F, Piazza S, Nazerian P, Conti A, Innocenti F, Ponchietti S, Bigiarini S, Guzzo A, Poggioni C, Taglia BD, Mariannini Y, Pini R. (2012). Verification of correct central venous catheter placement in the emergency department: comparison between ultrasonography and chest radiography. Available: https://www.ncbi.nlm.nih.gov/pubmed/23242559. Last accessed October-2017.
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    Yalda Farmani Anoosheh, Saeed Abbasi, Mani Mofidi. (2017). Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography. Advances in Surgical Sciences, 5(6), 69-72. https://doi.org/10.11648/j.ass.20170506.11

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    Yalda Farmani Anoosheh; Saeed Abbasi; Mani Mofidi. Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography. Adv. Surg. Sci. 2017, 5(6), 69-72. doi: 10.11648/j.ass.20170506.11

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    AMA Style

    Yalda Farmani Anoosheh, Saeed Abbasi, Mani Mofidi. Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography. Adv Surg Sci. 2017;5(6):69-72. doi: 10.11648/j.ass.20170506.11

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  • @article{10.11648/j.ass.20170506.11,
      author = {Yalda Farmani Anoosheh and Saeed Abbasi and Mani Mofidi},
      title = {Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography},
      journal = {Advances in Surgical Sciences},
      volume = {5},
      number = {6},
      pages = {69-72},
      doi = {10.11648/j.ass.20170506.11},
      url = {https://doi.org/10.11648/j.ass.20170506.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20170506.11},
      abstract = {Introduction: Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Radiography and Sonography are two common procedures, which is used for localization of CVC. Due to volatile hemodynamic nature of patients, it is vital to follow CVC procedure and diagnose possible side effects and complications as soon as possible. Aim of current study is to assess efficacy, practicality and procedure time-curve between two aforementioned methods (Sonography Versus Radiography). After CV line preparation. Methodology: In current cross-sectional study we obtained 201 participants via convenient sampling method from Rasoul-E-Akram Hospital, Haftom-E-Tir Hospital and Firoozgar hospital. Participants were chosen from patients older than 18, who were admitted to ER or ICU in aforementioned hospitals and were candidate for CV line preparation. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Results: The average time of sonography procedure was estimated roughly 2.08 minutes, in which the maximum time was 5.5 minutes and the minimum time was 1.04 minutes. The standard deviation suggested that the sonography time for most of patients was about 2 minutes. Variance of sonography time among the above population was not reported. The data analysis showed that Chest X-Ray (CXR) time average for studied patients was about 40.82 minutes, in which the minimum time was 10 minutes and the maximum time was 150.15 minutes. The standard deviation of this variable suggested that variance level and CXR time difference among aforementioned patients were high (about 28.2). Bubble was found in the sonography of 199 cases and just two cases were excluded. According to these results, sensitivity of sonography was 99%, specificity was 100% and Kappa coefficient between sonography and radiography was 98%. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Sonography for Localization of Central Venous Catheter Location: A Reliable Alternative to Radiography
    AU  - Yalda Farmani Anoosheh
    AU  - Saeed Abbasi
    AU  - Mani Mofidi
    Y1  - 2017/12/22
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ass.20170506.11
    DO  - 10.11648/j.ass.20170506.11
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 69
    EP  - 72
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20170506.11
    AB  - Introduction: Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Radiography and Sonography are two common procedures, which is used for localization of CVC. Due to volatile hemodynamic nature of patients, it is vital to follow CVC procedure and diagnose possible side effects and complications as soon as possible. Aim of current study is to assess efficacy, practicality and procedure time-curve between two aforementioned methods (Sonography Versus Radiography). After CV line preparation. Methodology: In current cross-sectional study we obtained 201 participants via convenient sampling method from Rasoul-E-Akram Hospital, Haftom-E-Tir Hospital and Firoozgar hospital. Participants were chosen from patients older than 18, who were admitted to ER or ICU in aforementioned hospitals and were candidate for CV line preparation. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Results: The average time of sonography procedure was estimated roughly 2.08 minutes, in which the maximum time was 5.5 minutes and the minimum time was 1.04 minutes. The standard deviation suggested that the sonography time for most of patients was about 2 minutes. Variance of sonography time among the above population was not reported. The data analysis showed that Chest X-Ray (CXR) time average for studied patients was about 40.82 minutes, in which the minimum time was 10 minutes and the maximum time was 150.15 minutes. The standard deviation of this variable suggested that variance level and CXR time difference among aforementioned patients were high (about 28.2). Bubble was found in the sonography of 199 cases and just two cases were excluded. According to these results, sensitivity of sonography was 99%, specificity was 100% and Kappa coefficient between sonography and radiography was 98%. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings.
    VL  - 5
    IS  - 6
    ER  - 

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Author Information
  • Emergency Medicine Management Research Center, Iran University of Medical Sciences, Rasoul Akram Hospital, Tehran, Iran

  • Emergency Medicine Management Research Center, Iran University of Medical Sciences, Rasoul Akram Hospital, Tehran, Iran

  • Emergency Medicine Management Research Center, Iran University of Medical Sciences, Rasoul Akram Hospital, Tehran, Iran

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