title: Agitated saline bubble-enhanced transthoracic echocardiography: a novel method to visualize the position of central venous catheter.
abstract: OBJECTIVE
  The purpose of this study is to describe a novel method to visualize the position of central venous catheters, which is safe, expeditious, and less expensive than the routine postprocedural chest radiograph.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Dialysis Center of the Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
  
  
  METHODS
  Two hundred and two adult patients undergoing central venous catheter placement for dialysis, plasmapheresis, or administration of medication and solutions.
  
  
  METHODS
  None.
  
  
  RESULTS
  Data of 202 adult patients with 219 central venous catheterizations were retrospectively analyzed. Each catheter insertion was followed by an agitated saline bubble-enhanced transthoracic echocardiography, which was used to localize the tip of the catheter. The position of catheter was then controlled by chest radiograph in all cases. During the 13-month study period, two catheter malpositions occurred. Both were identified by agitated saline bubble-enhanced transthoracic echocardiography and confirmed by chest radiograph. The mean time between catheter insertion and chest radiograph control (28.3 min) was clearly longer than agitated saline bubble-enhanced transthoracic echocardiography (3.2 min) (p < 0.001). The total costs of the procedure were reduced by 86.7-95.0%. Specific complications related to the procedure were not observed.
  
  
  CONCLUSIONS
  The results revealed that the accuracy of agitated saline bubble-enhanced transthoracic echocardiography is equivalent to the chest radiograph. It offers a safe, cost-effective, expeditious alternative to routine chest radiograph for position controls of central venous catheters.
authors: All authors: Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Ming
authors: M
authors: Wen
authors: Konrad
authors: K
authors: Stock
authors: Uwe
authors: U
authors: Heemann
authors: Mario
authors: M
authors: Aussieker
authors: Claudius
authors: C
authors: Küchle
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D062905:Central Venous Catheters; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010956:Plasmapheresis / Q000295:instrumentation / Q000379:methods; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012965:Sodium Chloride
chemical_list: D012965:Sodium Chloride