Role of Ultrsonography in Detecting the Location of Tip of Percutaneous Central Venous Catheters in Neonates at Hi-Tech Medical College and Hospital, Bhubaneswar


Authors : Dr. Hemant Agrawal; Dr. Rakesh Panigrahi; Dr. Suryakanta Swain; Dr. Sidhant Swarup; Dr. Pankaj Garg

Volume/Issue : Volume 6 - 2021, Issue 6 - June

Google Scholar : http://bitly.ws/9nMw

Scribd : https://bit.ly/2TR4m2r

In most of the neonatal intensive care unit (NICU) percutaneous central venous catheters (PCVCs) are mostly used for supplementation of fluid, medication and parenteral nutrition administration. In India most of the NICUs routinely use conventional chest abdomen radiography (CXR) procedure for detecting the position of tip of PCVCs. Real-time ultrasonography (RTUS) at bedside for procedural guidance has seen increased use in pediatric emergency medicine and pediatric critical care to reduce procedural time and burden, decrease radiation exposure, and minimize potential complications. There are certain life threatening complications such as pleural effusion, pericardial effusion and cardiac tamponade associated with insertion of PCVCs in upper extremities in comparison to PCVCs inserted in lower extremities. Therefore in this study we had opted insertion of PCVCs in lower extremities. Methods:- The study is a prospective cohort study, done in NICU at Hi-Tech medical college and hospital, Bhubaneswar from August 2019 to December 2020 in the neonatal patients who needed and received PCVC insertion in their lower extremities. The data of neonatal patients who received PCVC insertion from June 2018 to July 2019 and whose catheter tip location was confirmed by CXR only were also included and reviewed retrospectively. All neonates who received PCVC from 2018 to 2020 were divided into 2 groups named as Ultrasonography group (USG group) and Conventional chest abdomen radiography group (CXR group). In USG group the tip locations of the PCVCs were evaluated by USG and confirmed by CXR and in CXR group it was confirmed by CXR only. The neonatal patients gestational age, post-menstrual age, gender, birth weight and body weight on the procedure date along with the withdrawal rate and duration of tip confirmation was noted. Complications of PCVC insertion like phlebitis, leakage, occlusion and catheter related infection were also noted.

Keywords : Neonate, Ultrasonography, Catheter, Complication

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