title: The use of ultrasound during and after central venous catheter insertion versus conventional chest X-ray after insertion of a central venous catheter.
abstract: BACKGROUND
  After insertion of a central venous catheter (CVC) a conventional chest X-ray (CXR) is usually taken to check for complications and correct position. Ultrasound might be equally effective as CXR and is less time consuming. We studied the use of ultrasound versus CXR after insertion of a CVC in general ward patients.
  
  
  METHODS
  General ward patients in need of a CVC were included. CVCs were inserted under direct ultrasound guidance. After insertion, ultrasound was performed and compared with CXR to check for complications and position. The waiting time for CXR was noted.
  
  
  RESULTS
  In total, 53 patients were included. In 52/53 patients ultrasound was feasible. The results of ultrasound and CXR only differed in 3 of 53 patients. The sensitivity of ultrasound in detecting the correct CVC position was 98% (89.4-100%). No complications were detected (ultrasound or CXR). The median waiting time for CXR was 24.5 minutes.
  
  
  CONCLUSIONS
  Our study shows that an integral use of ultrasound during and after CVC insertion is effective in establishing that the CVC is correctly positioned and for identifying post-procedural complications in patients from the general ward when compared with CXR.
authors.affiliation: Department of Internal Medicine and Intensive Care, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Blans
authors.forename: H
authors.initials: H
authors.lastname: Endeman
authors.forename: F H
authors.initials: FH
authors.lastname: Bosch
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D013902:Radiography, Thoracic; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*