Feasibility of a new ultrasound guided procedure to ensure the correct position of the central venous catheter tip. in The American journal of emergency medicine / Am J Emerg Med. 2024 Oct;84:39-44. doi: 10.1016/j.ajem.2024.07.042. Epub 2024 Jul 27.

2024
ASL Torino 3
AOU San Luigi di Orbassano

Tipo pubblicazione

Journal Article

Autori/Collaboratori (8)Vedi tutti...

Lodo F
Anesthesia and Intensive Care Unit, Rivoli Hospital, Rivoli, Italy.
Russo R
Department of Anesthesia and Critical Care, San Luigi Gonzaga University Hospital, Orbassano, Italy.
Cardinale L
Radiology Unit, Pinerolo Hospital, Pinerolo, Italy.

et alii...

Abstract

BACKGROUND: Safety of central venous catheter (CVC) placement relies on some general aspects, including selection of the right vessel, correct lumen targeting while inserting the needle, check the position of catheter tip, and post-procedure check for complications. All these four points can be guided by bedside ultrasound, but the best technique to ensure the position of the CVC tip is still uncertain. METHODS: We investigated feasibility of a novel ultrasound technique consisting of focused view of guidewire tip in the cavoatrial junction (CAJ) to calculate the CVC depth in adult patients needing CVC placement in emergency. Direct visualization of the guidewire in the CAJ was used to calculate how deep the CVC needed to be inserted. In those patients without a valid CAJ window, a bubble test in the right atrium was performed to position the CVC tip. In all cases chest radiography confirmed the CVC position. RESULTS: The procedure was performed in 37 patients and CVC was correctly placed in all cases. Within the group, in 25 patients the CVC depth (21.5 ± 6.0 cm) was successfully measured. In other 11 patients the correct CVC tip position was confirmed by the bubble test. In only one case it was not possible to use ultrasound for incomplete CAJ and right atrium views. CONCLUSIONS: This study confirms the feasibility of a new ultrasound method to ensure the correct CVC tip position. This protocol could potentially become a standard method reducing costs, post-procedural irradiation, and time of CVC placement in emergency.

Accesso banca dati bibliografica

PMID : 39084045

DOI : 10.1016/j.ajem.2024.07.042

Keywords

Point-of-Care Systems; Adult; Central Venous Catheters; Aged; Middle Aged; Female; Male; Ultrasonography, Interventional/methods; Catheterization, Central Venous/methods; Feasibility Studies; Humans; Central venous access; Central venous catheter; Emergency ultrasound; Ultrasound guidance;