The Ultrasound‐Only Central Venous Catheter Placement and Confirmation Procedure

Abstract

The placement of a central venous catheter remains an important intervention in the care of critically ill patients in the emergency department. We propose an ultrasound‐first protocol for 3 aspects of central venous catheter placement above the diaphragm: dynamic procedural guidance, evaluation for pneumothorax, and confirmation of the catheter tip location.

Ultrasound for Localization of Central Venous Catheter: A Good Alternative to Chest X-Ray?

“…Some of these studies described ultrasonography as an accurate method for identifying catheter location and avoiding life-threatening complications, such as pneumothorax (12-15, 17-19). Maury and colleagues reported a high success rate of ultrasonic evaluation in detecting aberrant catheter location and pneumothorax (14).…”

“…In this situation, chest radiography is usually performed postoperatively in the ICU, and the time delay could be harmful to patients. In recent years, some researchers have proposed real-time assessment of catheter location using various ultrasound techniques as an alternative to chest radiography (12-19). …”

Agitated Saline Bubble−Enhanced Ultrasound for Assessing Appropriate Position of Hemodialysis Central Venous Catheter in Critically Ill Patients

“…The use of ultrasound guidance for the placement of central venous catheters in critically ill patients is recommended. 2 , 3 , 6 , 7 This recommendation applies to critically patients requiring placement of a hemodialysis catheter for grade 3 AKI. Given the presence of a sonographer during catheter insertion, it is logical to use ultrasound for assessing adequate positioning at the end of the procedure.…”

“…Ultrasound-guided insertion of hemodialysis catheter is recommended for vascular access. 1 , 2 , 3 Agitated saline bubble−enhanced ultrasound is efficient and rapid to ensure the correct positioning of central venous cateter in critically ill patients. Delayed appearance of microbubbles in the right atrium 4 indicates inadequate positioning.…”

Which monitoring methods can we use in patients undergoing cardiac surgery?

“…Aynı zamanda kateter yerinin belirlenmesi için de kullanılmaktadır. [1] En sık 7F 20 cm multi lümen kateter kullanılmaktadır. Vasküler hasar ve havayolunu ilgilendiren mekanik komplikasyonlardan tromboemboli, enfeksiyon ya da kateterin yanlı kullanımına varan bir dizi komplikasyon kateterizasyon sırasında ortaya çıkabilir.…”