Clin Exp Emerg Med.  2018 Jun;5(2):71-75. 10.15441/ceem.16.189.

Usefulness of ultrasonography for the evaluation of catheter misplacement and complications after central venous catheterization

• Kim YI
• Ryu JH
• Min MK
• Park MR
• Park SC
• Yeom SR
• Han SK
• Park SW
• Lee SH

• KMID: 2416918
• DOI: http://doi.org/10.15441/ceem.16.189

Abstract

OBJECTIVE
To assess whether ultrasonographic examination compared to chest radiography (CXR) is effective for evaluating complications after central venous catheterization.
METHODS
We performed a prospective observational study. Immediately after central venous catheter insertion, we asked the radiologic department to perform a portable CXR scan. A junior and senior medical resident each performed ultrasonographic evaluation of the position of the catheter tip and complications such as pneumothorax and pleural effusion (hemothorax). We estimated the time required for ultrasound (US) and CXR.
RESULTS
Compared to CXR, US could equivalently identify the catheter tip in the internal jugular or subclavian veins (P=1.000). Compared with CXR, US examinations conducted by junior residents could equivalently evaluate pneumothorax (P=1.000), while US examinations conducted by senior residents could also equivalently evaluate pneumothorax (P=0.557) and pleural effusion (P=0.337). The required time for US was shorter than that for CXR (P < 0.001).
CONCLUSION
Compared to CXR, US could equivalently and more quickly identify complications such as pneumothorax or pleural effusion.

Keyword

Diagnostic imaging; Catheterization, central venous; Complications; Ultrasonography

MeSH Terms

Catheterization, Central Venous*
Catheters*
Central Venous Catheters*
Diagnostic Imaging
Observational Study
Pleural Effusion
Pneumothorax
Prospective Studies
Radiography
Subclavian Vein
Thorax
Ultrasonography*