Ultrasound detection of guidewire position during central venous catheterization.
BACKGROUND
Ultrasound guidance decreases complications of central venous catheter (CVC) placement, but risks of arterial puncture and inadvertent arterial catheter placement exist. Ultrasound-assisted detection of guidewire position in the internal jugular vein could predict correct catheter position before dilation and catheter placement.


METHODS
Ultrasound examinations were performed in an attempt to identify the guidewire before dilation and catheter insertion in 20 adult patients requiring CVC placement. Central venous pressures were measured after completion of the procedure.


RESULTS
Guidewires were visible within the lumen of the internal jugular vein in all subjects. Central venous pressures confirmed venous placement of catheters. Ultrasound visualization of the guidewire predicted venous CVC placement with 100% sensitivity (95% confidence interval 80-100%) and 100% specificity (95% confidence interval 80%-100%).


CONCLUSIONS
Ultrasound reliably detects the guidewire during CVC placement and visualization of the wire before dilation and catheter insertion may provide an additional measure of safety during ultrasound-guided CVC placement.
Stone
Michael B
MB
Department of Emergency Medicine, SUNY Downstate, Brooklyn, NY 11203, USA. sunysono@gmail.com
Nagdev
Arun
A
Murphy
Michael C
MC
Sisson
Craig A
CA
D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D002496:Central Venous Pressure; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography