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- Title
Ultrasound localization of central vein catheter tip by contrast-enhanced transthoracic ultrasonography: a comparison study with trans-esophageal echocardiography.
- Authors
Corradi, Francesco; Guarracino, Fabio; Santori, Gregorio; Brusasco, Claudia; Tavazzi, Guido; Via, Gabriele; Mongodi, Silvia; Mojoli, Francesco; Biagini, Raffaello Umberto Dario; Isirdi, Alessandro; Dazzi, Federico; Robba, Chiara; Vetrugno, Luigi; Forfori, Francesco; UCARE research group; Bologna, Maria Lidia; Cardu, Alessandro; Crocetti, Laura; Cundari, Francesco; Del Frate, Elisa
- Abstract
<bold>Background: </bold>To assess the usefulness of pre-operative contrast-enhanced transthoracic echocardiography (CE-TTE) and post-operative chest-x-ray (CXR) for evaluating central venous catheter (CVC) tip placements, with trans-esophageal echocardiography (TEE) as gold standard.<bold>Methods: </bold>A prospective single-center, observational study was performed in 111 patients requiring CVC positioning into the internal jugular vein for elective cardiac surgery. At the end of CVC insertion by landmark technique, a contrast-enhanced TTE was performed by both the apical four-chambers and epigastric bicaval acoustic view to assess catheter tip position; then, a TEE was performed and considered as a reference technique. A postoperative CXR was obtained for all patients.<bold>Results: </bold>As per TEE, 74 (67%) catheter tips were correctly placed and 37 (33%) misplaced. Considering intravascular and intracardiac misplacements together, they were detected in 8 patients by CE-TTE via apical four-chamber view, 36 patients by CE-TTE via epigastric bicaval acoustic view, and 12 patients by CXR. For the detection of catheter tip misplacement, CE-TTE via epigastric bicaval acoustic view was the most accurate method providing 97% sensitivity, 90% specificity, and 92% diagnostic accuracy if compared with either CE-TTE via apical four-chamber view or CXR. Concordance with TEE was 79% (p < 0.001) for CE-TTE via epigastric bicaval acoustic view.<bold>Conclusions: </bold>The concordance between CE-TTE via epigastric bicaval acoustic view and TEE suggests the use of the former as a standard technique to ensure the correct positioning of catheter tip after central venous cannulation to optimize the use of hospital resources and minimize radiation exposure.
- Subjects
ECHOCARDIOGRAPHY; ULTRASONIC imaging; CENTRAL venous catheterization; TRANSESOPHAGEAL echocardiography; CENTRAL venous catheters; LONGITUDINAL method
- Publication
Critical Care, 2022, Vol 26, Issue 1, p1
- ISSN
1364-8535
- Publication type
journal article
- DOI
10.1186/s13054-022-03985-3