title: Confirmation of endovenous placement of central catheter using the ultrasonographic "bubble test".
abstract: Insertion of central venous catheter (CVC) is the most common procedure to be performed in Intensive Care Units. Addition of ultrasonographic guidance to this procedure, which was initially performed blindly, has improved safety of this procedure. Confirmation of endovenous placement of CVC though, is tricky, as methods for confirmation are either operator dependent, time-consuming or not available at bedside. Prospective observational study was carried out to study feasibility of use of sonobubble test to confirm the presence of CVC within central vein. After insertion of CVC in the internal jugular, subclavian or axillary vein, a 10 ml bolus of shaken saline microbubble is injected through port of CVC, and opacification of right atrium is observed in xiphoid view on ultrasonography. The Sonobubble test was helpful for dynamic confirmation of endovenous placement of CVC and prevented complications such as arterial puncture and cannulation. We recommend its use following CVC insertion.
authors.affiliation: Department of Anesthesia, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India.
authors.forename: Ajit S
authors.initials: AS
authors.lastname: Baviskar
authors.affiliation: Department of Medicine, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India.
authors.forename: Khalid I
authors.initials: KI
authors.lastname: Khatib
authors.affiliation: Department of Emergency Medicine, AIIMS Trauma Centre, New Delhi, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bhoi
authors.affiliation: Department of Emergency Medicine, University of South Florida, Tampa, Florida, USA.
authors.forename: Sagar C
authors.initials: SC
authors.lastname: Galwankar
authors.affiliation: Department of Anesthesia, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India.
authors.forename: Harshad C
authors.initials: HC
authors.lastname: Dongare
keywords: Bubble test; central venous catheter; ultrasonography