84 results match your criteria: "Bedside Ultrasonography Central Line Placement"
Article Synopsis
- The safety of central venous catheter (CVC) placement depends on proper vessel selection, accurate needle targeting, and confirmation of tip position, which can be guided by bedside ultrasound.* -
- A novel ultrasound technique was tested on 37 adult patients needing CVC placement, successfully determining the correct depth using direct visualization of the guidewire tip at the cavoatrial junction (CAJ).* -
- Results showed successful CVC placement in all cases, suggesting this new method could standardize the process, lower costs, and reduce radiation exposure during emergency procedures.*
Should all critical care patients with a central venous catheter in situ be screened for central catheter related thrombosis?
Br J Hosp Med (Lond)
May 2024
Department of Anaesthesia, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK.
Article Synopsis
- There are limited studies specifically on central catheter related thrombosis (CCRT) in adults in critical care, despite many studies on CCRT in general.
- Research involving bedside duplex ultrasound has shown that the incidence of CCRT ranges from 17-38%, with most cases identified within a week of catheter insertion.
- Almost all cases of CCRT are asymptomatic, lacking serious complications like pulmonary embolism or significant mortality impacts, leading to the recommendation against routine screening for CCRT in these patients.
Validating the anatomical landmark technique for bedside tunneled central venous catheter placement in the medical intensive care unit.
J Vasc Access
April 2024
John D Dingell VAMC, Detroit, MI, USA.
Article Synopsis
- Non-tunneled dialysis catheters (nTDCs) are commonly used for dialysis in ICU patients, and if they need dialysis for more than two weeks, they can either be replaced or switched to tunneled dialysis catheters (TDCs).
- This study aimed to assess the safety and effectiveness of placing TDCs and other tunneled central venous catheters (tCVCs) using anatomical landmarks instead of the standard fluoroscopic guidance.
- Out of 111 catheters placed using this technique, 110 had the correct tip placement, with few major complications, although a significant number (18 out of 111) were placed in patients who did not
Analysis of tip malposition and correction of peripherally inserted central catheters under ultrasound-guidance: 5-year outcomes from a single center.
J Vasc Access
December 2023
Division of Vascular and Transplant Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, Republic of Korea.
Article Synopsis
- The study investigates the rates of malposition in peripherally inserted central catheters (PICC) placed using ultrasound guidance, analyzing data from 5,981 patients over four years.
- Results showed that while 81.7% of catheter placements were optimal, 5% were malpositioned, with certain factors like height and body mass index significantly linked to malposition.
- The research concluded that ultrasound guidance helps minimize complications, and patients with specific risk factors should be monitored more closely during the procedure.
Development and validation of an updated PICC length prediction formula based on anteroposterior chest radiographs for the ultrasound-guided bedside placement.
PLoS One
November 2023
Department of Radiology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
Article Synopsis
- Researchers developed a new formula to accurately predict the optimal length of a peripherally inserted central catheter (PICC) for patients who can't be easily transported during hospital stays.
- The study involved analyzing data from PICC placements across three hospitals, measuring factors like arm length and distances from various anatomical landmarks, ultimately including 400+ patients in the research.
- The derived formula shows high effectiveness, achieving 90.1% accuracy in positioning the catheter tip correctly, demonstrating its reliability for bedside PICC placements based solely on chest X-rays.
Feasibility of Ultrasound-Guided, Peripherally Inserted Central Catheter Placement at the Bedside in a Communicable-Disease Isolation Unit.
J Pers Med
May 2023
Division of Acute Care Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
Article Synopsis
- * Researchers used a handheld ultrasound device to assist with venous access and confirmed the catheter's tip location using either electrocardiography (ECG) or portable chest radiography.
- * Results indicated that the basilic vein in the right arm was the most common access point, and using ECG for tip confirmation significantly reduced the incidence of malposition compared to chest radiography (2.0% vs. 52.4%).
Fluoroscopically guided repositioning of peripherally inserted central catheter in patients failing ultrasound-guided-only placement: a retrospective five-year study.
Acta Radiol
June 2023
Department of Interventional Radiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, PR China.
Article Synopsis
- Ultrasound-guided insertion of PICCs is generally safe but can be tricky in special cases, leading to failures in placement.
- This study analyzed 1560 patients, finding that fluoroscopically guided tip repositioning successfully corrected issues in 32 individuals who failed the initial ultrasound-guided attempts, with minimal complications.
- The findings suggest that fluoroscopic adjustments can improve success rates and should be recommended for patients who experience difficulties with ultrasound-guided PICC placements.
Article Synopsis
- A 36-year-old woman with sickle cell disease experienced a painful crisis and had a central venous catheter (CVC) placed in her internal jugular vein after difficulty accessing peripheral veins.
- The catheter's unusual positioning was confirmed through ultrasound and a chest X-ray, showing it looped and terminating in the accessory hemiazygos vein instead of its intended location in the superior vena cava.
- Variants like the connection between the accessory hemiazygos vein and left superior intercostal vein can lead to such misplacements, which are rare and should be addressed by using proper tip-placement confirmation methods during insertion.
A feasible and safe standardized protocol for ultrasound and intracavitary electrocardiogram-based tip navigation and tip location during placement of peripherally inserted central catheters.
J Vasc Access
May 2024
Department of Clinical Nutrition, Peking Union Medical College Hospital, Beijing, China.
Article Synopsis
- The study investigates the use of ultrasound-guided tip navigation combined with intracavitary electrocardiogram (ECG) for confirming the placement of peripherally inserted central catheters (PICCs) in cancer patients.
- Data were collected from 1727 patients who underwent this combined method in 2020, comparing results to a control group from 2019 that used only ECG.
- The results showed that the ECG + US group had a significantly higher rate of optimal catheter tip placement and lower rates of misplacement compared to the ECG-only group, indicating that this method is both accurate and safe for clinical use.
Validation of the PICC length prediction formula based on anteroposterior chest radiographs for bedside ultrasound-guided placement.
PLoS One
November 2022
Department of Radiology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan-si, South Korea.
Article Synopsis
- This study assessed the reliability of a formula predicting PICC catheter length using anteroposterior chest X-rays (AP-CXR) and evaluated the feasibility of placing PICC catheters using bedside ultrasound.
- Conducted with 156 Asian adult patients across three hospitals, the research measured various anatomical parameters to calculate an estimated PICC length (eCL) before catheter placement.
- Results showed a technical success rate of 98.1%, with 70.6% of the catheter placements being in the optimal position, indicating the formula's effective accuracy and the procedure's practicality.
Comparison of bedside ultrasonography and bedside chest radiography in neonatal peripherally inserted central catheters: A before and after self-control study.
Front Pediatr
October 2022
Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China.
Article Synopsis
- - The study sought to compare bedside ultrasonography (US) and chest radiography (CR) for positioning peripherally inserted central venous catheters (PICC) in neonatal intensive care units, enrolling 181 neonate patients for the trial.
- - Results showed that US provided better visualization of key catheter structures, had lower data variability in measurements, required less operation time, and caused less drop in infants' body temperature compared to CR.
- - Additionally, the direct costs associated with CR were significantly higher than those of US, supporting the conclusion that US is the preferable method for PICC placement.
Confirmation of pleural displacement of central venous catheter tip in an infant, by bedside contrast injection.
J Vasc Access
January 2024
Department of Radiodiagnosis and Imaging, PGIMER Chandigarh, Chandigarh, India.
Article Synopsis
- - A 14-week-old infant with chronic respiratory distress was diagnosed with right-sided diaphragmatic eventration after chest imaging, leading to the insertion of a central venous catheter (CVC) for treatment.
- - Post-procedure, clear fluid drainage increased, raising suspicion of CVC displacement into the pleural cavity, although initial imaging did not confirm this.
- - A bedside radiograph with contrast injection ultimately revealed the displaced CVC tip in the mediastinal pleural space, prompting immediate removal of the catheter and establishment of a new venous access.
Ultrasound-Guided Umbilical Venous Catheter Insertion to Reduce Rate of Catheter Tip Malposition in Neonates: A Randomized, Controlled Trial.
Indian J Pediatr
November 2022
Department of Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, 400022, India.
Article Synopsis
- The study aimed to determine if using ultrasound guidance during umbilical venous catheter (UVC) insertion in neonates would lower the rate of catheter tip malpositioning compared to standard insertion methods.
- Results showed that the ultrasound group had a significantly lower malpositioning rate (42.3%) than the standard group (74%), which also led to fewer attempts and shorter procedure times.
- The findings suggest that ultrasound guidance not only improves catheter placement but also reduces unnecessary X-ray exposure, indicating it could be a valuable practice in NICUs with proper training.
Ultrasound-guided vascular access in the neonatal intensive care unit: a nationwide survey.
Eur J Pediatr
June 2022
Working Group On Ultrasound, Spanish Society of Neonatology (SENeo), Valencia, Spain.
Article Synopsis
- A nationwide survey was conducted to understand the perceptions and implementation of ultrasound-guided vascular access (USG-VA) among neonatologists in Spain, revealing that 81% see it as essential in clinical practice.
- Although many recognize its importance, 35.5% have never applied it on real patients, and most perform fewer than 5 procedures annually.
- The lack of proper training is considered the main barrier to its use, with 87% of neonatologists advocating for formal training in USG-VA for future doctors.
Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study.
Ann Noninvasive Electrocardiol
March 2022
Department of Oncology, Hebei General Hospital For Veterans, Xingtai, China.
Article Synopsis
- A study was conducted comparing electrocardiogram (ECG) and X-ray methods for locating the tip of peripherally inserted central catheters (PICCs) in critically ill cancer patients in Hebei Province, China.
- Out of 137 patients, specific P waves on ECG were detected in 130, indicating successful catheter placement, while 7 patients showed no changes in their P waves, and they were notably older.
- The findings suggest that using ECG for PICC tip localization can potentially replace unnecessary X-rays, but further evaluation is needed for elderly patients before catheter placement.
ECHOTIP: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in adult patients.
J Vasc Access
July 2023
Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Article Synopsis
- * Using ultrasound during procedures has decreased complications and is recommended by recent guidelines for better venipuncture and to assess veins beforehand.
- * This paper reviews how effective ultrasound is for guiding the placement and location of the catheter tip in adult patients and proposes a standardized protocol for its use in clinical settings.
Utility and futility of central venous catheterization.
Ann Card Anaesth
November 2021
Department of Anaesthesiology, Pain and Palliative Care and Critical Care Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Article Synopsis
- Central venous access is crucial for monitoring and treatment in hemodynamically unstable patients, but insertion can lead to serious complications like hemothorax.
- In a case involving a patient undergoing vestibular schwannoma surgery, CVC placement led to hemodynamic instability and complications after administering thiopentone for intubation.
- After diagnosing a large hemothorax through ultrasound and chest X-ray, a chest tube was placed, and the patient received additional treatment in the critical care unit, ultimately leading to stabilization and recovery.
ECHOTIP-Ped: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in pediatric patients.
J Vasc Access
January 2023
Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Article Synopsis
- * The use of ultrasound during procedures improves safety by aiding in vein selection and tip location, which lowers complications according to recent guidelines.
- * This paper reviews the effectiveness of ultrasound for navigating and locating tips of these devices in pediatric patients, proposing a structured protocol for better clinical practices.
Procedural Applications of Point-of-Care Ultrasound in Pediatric Emergency Medicine.
Emerg Med Clin North Am
August 2021
Department of Emergency Medicine, Stanford School of Medicine, 300 Pasteur Drive, Room M121, Alway Building MC 5768, Stanford, CA 94305, USA.
Article Synopsis
- Point-of-care ultrasound can enhance the effectiveness and safety of various pediatric procedures in the emergency department.
- The article discusses how ultrasound guidance can aid in soft tissue treatments, musculoskeletal and neurologic procedures, vascular access, and critical care interventions.
- By using ultrasound, emergency physicians can improve their skills and confidence while ensuring better outcomes for pediatric patients.
Confirmatory radiographs have limited utility following ultrasound-guided tunneled femoral central venous catheter placements by interventional radiology.
Pediatr Radiol
June 2021
Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA.
Article Synopsis
- Ultrasonography is effective in visualizing both correctly and incorrectly placed femoral-approach central venous catheters (CVCs) in pediatric patients, providing a reliable verification method.
- A study involving 484 patients found that 99.4% of the CVC placements were technically successful, with concordance between ultrasound and confirmatory radiographs showing catheter tip locations in all cases checked post-procedure.
- The research indicates that routine confirmatory radiographs after ultrasound-guided CVC placements may not be necessary, as ultrasounds alone effectively confirm tip position except in rare cases of complications.
Safety of bedside placement of tunneled dialysis catheter in COVID-19 patients.
J Vasc Access
January 2022
Department of Nephrology and Hypertension, Glickman Urological & Kidney Institute, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Article Synopsis
- - COVID-19 patients in the ICU frequently develop acute kidney injury (AKI) that requires extended renal replacement therapy, often involving tunneled dialysis catheters (TDC).
- - The text describes two successful cases where TDCs were placed at the bedside using ultrasound guidance and anatomical landmarks, rather than traditional fluoroscopy.
- - While fluoroscopy is the standard method for TDC placement, the bedside technique can be safe and effective for carefully selected patients, minimizing the risk of transferring COVID-19 infected individuals outside the ICU.
Perioperative Point-of-Care Ultrasound in Children.
Children (Basel)
November 2020
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Article Synopsis
- * POCUS helps with established procedures like central line and nerve block placement, along with diagnostics such as lung, cardiac, and gastric assessments.
- * The article reviews literature on the effectiveness of these ultrasound applications in improving patient care in pediatric anesthesiology.
Article Synopsis
- This study aimed to assess the effectiveness and safety of ultrasound-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) for use in neonates in the NICU.
- Over an 18-month period, 82 neonates were analyzed for procedural success and complications, finding a 100% success rate for placement and no complications arising from the insertions.
- The findings suggest that ST-FICCs can safely provide central venous access in neonates while avoiding risks related to other insertion methods, benefiting their care.
Diagnostic accuracy among trainees to safely confirm peripherally inserted central catheter (PICC) placement using bedside ultrasound.
Br J Nurs
October 2020
MD, University of Utah School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care, Salt Lake City, UT.
Article Synopsis
- The study aimed to assess whether novice ultrasound users could accurately confirm the placement of PICC lines using ultrasound, thereby improving efficacy and reducing radiation exposure.
- Conducted in a pediatric population, the study found that image quality was low, with wires only visualized 25% of the time and a 43% accuracy rate in identifying misplacements compared to traditional radiograph methods.
- While ultrasound showed promise for reducing radiation exposure, the results indicated that novice users did not perform better than chest X-rays, highlighting the need for improved technologies or techniques in pediatric ultrasound.
Ultrasound-Guided Peripheral Intravenous Catheter Insertion: The Nurse's Manual.
Crit Care Nurse
October 2020
Mark Bowers is a bedside nurse, 7 East Medical-Surgical, Lakeland Regional Health.
Article Synopsis
- Peripheral intravenous catheter placement is a common yet challenging skill for nurses, especially with complex vein access.
- Although ultrasound has been effectively used in emergency departments for 18 years to aid in this process, it hasn't gained the same traction in critical and acute care nursing.
- This article aims to educate bedside nurses on the techniques for using ultrasound to successfully place catheters in patients with difficult venous access, promoting better patient outcomes.