Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 21 , ISSUE 7 ( 2017 ) > List of Articles

CASE REPORT

Ultrasound Guidance for Central Venous Catheterization: A Step Further to Prevent Malposition of Central Venous Catheter Before Radiographic Confirmation

Devinder Midha, Amit Kumar Mandal

Keywords : Central venous catheter, malposition, ultrasound

Citation Information : Midha D, Mandal AK. Ultrasound Guidance for Central Venous Catheterization: A Step Further to Prevent Malposition of Central Venous Catheter Before Radiographic Confirmation. Indian J Crit Care Med 2017; 21 (7):463-465.

DOI: 10.4103/ijccm.IJCCM_61_17

License: CC BY-ND 3.0

Published Online: 01-07-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Ultrasound (USG) guidance has long been used for guiding central venous catheterization. USG provides direct visualization of needle puncture through the skin into the vein. Most of the time USG guidance is just limited to puncturing of the vein and seeing guidewire entering the vein while malpositioning of catheter occurs after that which is seen later on while checking chest radiograph. Repositioning of catheter after that becomes not only difficult requiring repeated chest radiograph to reconfirm position of catheter but also increases chances of infection with repeated manipulations. USG guidance can be used for tracing both guidewire and catheter during the procedure to prevent malpositioning of catheter, thus when done at the right time can prevent complication related to malpositioning and repeated manipulations. We used linear USG probe to check malposition of guidewire and microconvex probe to confirm position of central venous catheter.


PDF Share
  1. Malatinský J, Kadlic T, Májek M, Sámel M. Misplacement and loop formation of central venous catheters. Acta Anaesthesiol Scand 1976;20:237-47.
  2. Ruesch S, Walder B, Tramer MR. Complications of central venous catheters: Internal jugular versus subclavian access – A systematic review. Crit Care Med 2002;30:454-60.
  3. Tsai YS, Huang JK, Cheng SJ, Fan YK. Malposition of a central venous catheter causing intracranial septic thrombophlebitis. Chin J Radiol 2006;31:109-13.
  4. American Society of Anesthesiologists Task Force on Central Venous Access, Rupp SM, Apfelbaum JL, Blitt C, Caplan RA, Connis RT, et al. Practice guidelines for central venous access: A report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology 2012;116:539-73.
  5. Sanchez R, Halck S, Walther-Larsen S, Heslet L. Misplacement of subclavian venous catheters: Importance of head position and choice of puncture site. Br J Anaesth 1990;64:632-3.
  6. Schummer W, Schummer C, Schelenz C, Brandes H, Stock U, Müller T, et al. Central venous catheters – The inability of 'intra-atrial ECG' to prove adequate positioning. Br J Anaesth 2004;93:193-8.
  7. Weekes AJ, Johnson DA, Keller SM, Efune B, Carey C, Rozario NL, et al. Central vascular catheter placement evaluation using saline flush and bedside echocardiography. Acad Emerg Med 2014;21:65-72.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.