Abstract
Introduction: Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Radiography and Sonography are two common procedures, which is used for localization of CVC. Due to volatile hemodynamic nature of patients, it is vital to follow CVC procedure and diagnose possible side effects and complications as soon as possible. Aim of current study is to assess efficacy, practicality and procedure time-curve between two aforementioned methods (Sonography Versus Radiography). After CV line preparation. Methodology: In current cross-sectional study we obtained 201 participants via convenient sampling method from Rasoul-E-Akram Hospital, Haftom-E-Tir Hospital and Firoozgar hospital. Participants were chosen from patients older than 18, who were admitted to ER or ICU in aforementioned hospitals and were candidate for CV line preparation. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Results: The average time of sonography procedure was estimated roughly 2.08 minutes, in which the maximum time was 5.5 minutes and the minimum time was 1.04 minutes. The standard deviation suggested that the sonography time for most of patients was about 2 minutes. Variance of sonography time among the above population was not reported. The data analysis showed that Chest X-Ray (CXR) time average for studied patients was about 40.82 minutes, in which the minimum time was 10 minutes and the maximum time was 150.15 minutes. The standard deviation of this variable suggested that variance level and CXR time difference among aforementioned patients were high (about 28.2). Bubble was found in the sonography of 199 cases and just two cases were excluded. According to these results, sensitivity of sonography was 99%, specificity was 100% and Kappa coefficient between sonography and radiography was 98%. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings.
Highlights
Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and intensive care unit (ICU) settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure
In a study conducted by Maury and Colleagues (2001), they postulated that ultrasonic diagnosis of catheter misplacement and pneumothorax related to central venous catheterization is a quick and precise approach, which can be accomplished by ICU physicians [16]
In another study conducted by Vezzani and Colleagues (2010), they assessed Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax; they reported that high concordance between ultrasonography plus contrast improved ultrasonography and Chest XRay (CXR) validates implication of sonography as a reliable approach to confirm the precise localization of the catheter tip and to notice pneumothorax after central venous catheter cannulation [17]
Summary
Localization of Control Venous Catheter (CVC) is essential in emergency (ER) and ICU settings; accurately confirming of the location of CVC may enable clinician to minimize the risk of the procedure. Following CVC procedure, physicians proceeded with radiography and sonography among all patients and compared approaches with respect to, timing, confirmation of catheter location and post CVC complications. Conclusion: All in all, with respect to high correlation in accurate localization of CVC in both approaches (radiography and sonography) plus competitive advantage of sonography over radiography by maintaining shorter time in confirmation of CVC location, sonography can be discussed as optimum and routine modality with respect catheter location confirmation in emergency settings. In another study conducted by Vezzani and Colleagues (2010), they assessed Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax; they reported that high concordance between ultrasonography plus contrast improved ultrasonography and CXR validates implication of sonography as a reliable approach to confirm the precise localization of the catheter tip and to notice pneumothorax after central venous catheter cannulation [17]. They reported that Ultrasound could confirm CVC placement and rule out pneumothorax considerably quicker than CXR, accelerating the use of CVCs in the critically ill [19]
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