Exclusion of complications of central venous catheters: Ultrasound versus X-ray

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Published Aug 24, 2023
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Vol. 101 No. 3 (2023): Tunis Med mars 2023

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Mahmoud Marzouk
a:1:{s:5:"fr_FR";s:31:"Faculté de médecine de Tunis ";}
Oussama Nasri
Institut Mohamed Kassab d'orthopédie, Faculté de médecine de Tunis
Rabeb Hammami
Institut national Mongi Ben Hmida de neurologie Faculté de médecine de Tunis
Chadha Ben Messaoud
Institut Mohamed Kassab d'orthopédie, Faculté de médecine de Tunis
Saber Thamlaoui
Institut national Mongi Ben Hmida de neurologie Faculté de médecine de Tunis
Nader Baffoun
Institut national Mongi Ben Hmida de neurologie Faculté de médecine de Tunis
Olfa Kaabachi
Institut Mohamed Kassab d'orthopédie, Faculté de médecine de Tunis
Chokri Kaddour
Institut national Mongi Ben Hmida de neurologie Faculté de médecine de Tunis

Abstract

Introduction: The placement of central venous catheters (CVC) is a frequent procedure in intensive care. It is not devoid of complications, the diagnosis of which relied for a long time on the chest X-ray. Currently, ultrasound appears to be an interesting alternative.


Aim : To report the impact of the use of ultrasound on the time to exclusion of mechanical complications after CVC placement.


Methods : This is a prospective, multicenter, comparative, double-blind study. Were included the patients in whom the placement of a CVC was decided. After placement, a chest X-ray was ordered and an ultrasound was performed to look for signs of misplacement and pneumothorax. The two examinations were interpreted by two different doctors. The primary endpoint between the ultrasound group and the RTX group was the time “T1” represented by the time required to exclude complications.


Results : 30 patients were included in our study. The mean ultrasound T1time was significantly lower than the mean radiological T1time (p=0.000). Only one case of pneumothorax was observed. It was first detected by ultrasound. For the 29 other patients, exclusion of pneumothorax was confirmed by ultrasound and chest X-ray. No misplacement type complications detected. This was confirmed by ultrasound and radiological exclusions.


Conclusion : Ultrasound is a faster tool than RTX in excluding mechanical complications after CVC placement. It guarantees a non-irradiating examination as efficient as chest X-ray for intensive care patients.

Keywords:

Central venous catheters, ultrasonography, pneumothorax, complications, thoracic radiography

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