The Use of Targeted Neonatal Echocardiography to Confirm Placement of Peripherally Inserted Central Catheters in Neonates
The Use of Targeted Neonatal Echocardiography to Confirm Placement of Peripherally Inserted Central Catheters in Neonates
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DOI：
10.1055/s-0031-1295649
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发表时间：
2012-02-01
影响因子：
2
通讯作者：
El-Khuffash, Afif
中科院分区：
文献类型：
--
作者：
Jain, Amish;McNamara, Patrick J.;El-Khuffash, Afif
使用 X 线平片来评估经外周静脉置入中心静脉导管 (PICC) 导管尖端的正确位置并不总是准确的。超声波可能是检测尖端位置并有助于线路操作的更好方式。我们评估了在三级新生儿重症监护病房中，与使用靶向新生儿超声心动图 (TnECHO) 相比，平片在确定 PICC 导管尖端位置方面的准确性。插入 PICC 后，在第一张 X 光片后使用 TnECHO 确认尖端位置。构建了 2 x 2 表来比较两种模式检测线位置的能力。该研究共纳入 22 名婴儿，妊娠期为 26.5 周（25.4 至 28.8），出生体重为 833 克（710 至 1930 年）。 13 名婴儿 (59%) 的 PICC 导管尖端位置的 X 线照片与 TnECHO 之间存在一致性。 X 线照片确定位置不正的敏感性为 64%，特异性为 55%。三名婴儿被错误地识别为深纹，两名婴儿被错误地识别为短纹。在 9 名婴儿 (41%) 中，使用 TnECHO 进行线操作后避免了第二次 X 光检查。 TnECHO 是一种有用的工具，可用于识别尖端位置、执行实时操作以及最大限度地减少进一步射线照片的曝光。
The use of plain radiographs in assessing the correct position of peripherally inserted central catheter (PICC) line tips is not always accurate. Ultrasound may be a better modality in detecting tip position and aid in line manipulation. We assessed the accuracy of plain radiographs in determining PICC line tip position compared with using targeted neonatal echocardiography (TnECHO) in a tertiary neonatal intensive care unit. Following PICC insertion, tip position was confirmed using TnECHO after the first radiograph. A 2 x 2 table was constructed to compare the two modalities' ability to detect line position. A total of 22 infants were included in the study with a gestation of 26.5 weeks (25.4 to 28.8) and birth weight of 833 g (710 to 1930). Concordance between radiographs and TnECHO for PICC line tip position occurred in 13 infants (59%). Sensitivity of radiographs in determining malposition was 64% with a specificity of 55%. Three infants were incorrectly identified to have deep lines and two infants were incorrectly identified to have short lines. In nine infants (41%), a second radiograph was avoided following line manipulation using TnECHO. TnECHO is a useful tool in identifying tip position, performing real-time manipulation, and minimizing exposure to further radiographs.