Document Type : original article
Authors
1 SMVMCH Madagadipet Puducherry-605107
2 42, Assistant Professor Quarters SMVMCH Madagadipet Puducherry-605107
Abstract
Background :Central lines like umbilical vein catheter (UVC) and peripherally inserted
central catheter (PICC) are essential for administration of drugs, nutrition, and blood
products in neonates. Radiography is routinely done to ensure optimal positioning but cannot
detect the last segment of the umbilical vein course as it is in the sagittal plane. Hence we
studied the efficacy of Point Of Care Ultrasound (POCU) in detecting the central line tip
position in neonates .
Methods: A prospective observational comparative diagnostic accuracy study done in
neonates who underwent central line insertion (n=51) in NICU for a study period of 18
months. After placing UVC/ PICC, Xray and USG was done to locate the tip of the central
line.
Results: Out of the 51 central line studied, 49 were UVC and 2 were PICC line. USG was
able to identify all the malpositioned (n=38) and optimally placed central line tips (n=10) as
seen in Xrayand also additionally identified the (n=3) doubtful tips on X-ray as malpositioned
(n= 1) and optimally placed (n=2). 78.9% (n=30) UVC were low lying and the most common
malpositioned site on USG was intrahepatic IVC (66.66 %) . On analyzing the accuracy
parameters for diagnostic tests, our study found that USG has a sensitivity of 94.7% ,
specificity of 76.9 %, PPV of 92.3 % and NPV of 83.3 %.
Conclusion: POCU is a safe, quick, bedside diagnostic modality for accurately identifying the
central line tip position in neonates.
Keywords
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