Abstract
Objective
To assess feasibility of ultrasound (USG) evaluation of tip position of central catheter in neonates and to determine agreement between radiograph and USG-based assessments.
Methods
This prospective observational study was conducted in a tertiary neonatal intensive care unit from April, 2019 to August, 2019. Point of care USG and radiograph were performed on infants who underwent central line placement. Agreement between the two was determined using Kappa statistics.
Results
Of the 141 central catheters insertions performed, USG was performed for 65 central catheters. On USG, catheter tip position could be assessed and defined in 62 (95%) of cases. Of these 62 central lines, 24 (38.7%) were defined as optimally placed on radiograph and 20 (32.2%) were defined as optimally placed on USG. There was excellent agreement between radiographic and USG assessment of catheter tip position [K (95% CI) = 0.86 (0.73–0.99), P < 0.001]. All 38 lines found to be mal-positioned on radiograph were assessed as suboptimal on USG as well.
Conclusion
Point of care USG has excellent agreement with radiography for confirming central line tip position.
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Ethical Clearance
Ethics Committee, Sir Ganga Ram Hospital; EC/12/18/1454, dated December 18, 2018.
Contributors
AT: conceptualized the project and developed the protocol; AT: had primary responsibility of patient screening, enrolment and data collection; AT: performed the data analysis; AT,VK: wrote the manuscript; NK, PG: participated in protocol development, supervising enrolment, outcome assessment and in writing the manuscript; AT, MM: participated in planning of project and writing of manuscript.
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Thakur, A., Kumar, V., Modi, M. et al. Use of Point of Care Ultrasound for Confirming Central Line Tip Position in Neonates. Indian Pediatr 57, 805–807 (2020). https://doi.org/10.1007/s13312-020-1957-9
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DOI: https://doi.org/10.1007/s13312-020-1957-9