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

Autor: Oliveira L; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil. leila_oliv@hotmail.com., Pilz L; Medical Student, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil., Tognolo CM; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Bischoff C; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Becker KA; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Oliveira GG; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Neves PJF; Medical Student, Universidade Federal Do Paraná, Curitiba, Paraná, Brazil., Fachin CG; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Agulham MA; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil., Dias AIBS; Pediatric Surgery Department, Hospital de Clínicas, Universidade Federal Do Paraná, Pedro Viriato Parigot de Souza, 1609/602, Curitiba, Paraná, CEP 81200-100, Brazil.
Jazyk: angličtina
Zdroj: Pediatric surgery international [Pediatr Surg Int] 2020 May; Vol. 36 (5), pp. 563-568. Date of Electronic Publication: 2020 Mar 30.
DOI: 10.1007/s00383-020-04642-y
Abstrakt: 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.
Databáze: MEDLINE
Externí odkaz: