Marzouk Mahmoud, Nasri Oussama, Hammami Rabeb, Ben Messaoud Chadha, Thamlaoui Saber, Baffoun Nader, Kaabachi Olfa, Kaddour Chokri
Kassab Institute of Orthopaedics, Tunis, Tunisia, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
Mongi Ben Hmida National Institute of Neurology, Tunis, Tunisia, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
Tunis Med. 2023 Mar 5;101(3):351-355.
The placement of central venous catheters (CVC) is a frequent procedure in intensive care. It is not devoid of complications, the diagnosis of which relied for a long time on the chest X-ray. Currently, ultrasound appears to be an interesting alternative.
To report the impact of the use of ultrasound on the time to exclusion of mechanical complications after CVC placement.
This is a prospective, multicenter, comparative, double-blind study. Were included the patients in whom the placement of a CVC was decided. After placement, a chest X-ray was ordered and an ultrasound was performed to look for signs of misplacement and pneumothorax. The two examinations were interpreted by two different doctors. The primary endpoint between the ultrasound group and the RTX group was the time "T1" represented by the time required to exclude complications.
30 patients were included in our study. The mean ultrasound T1time was significantly lower than the mean radiological T1time (p=0.000). Only one case of pneumothorax was observed. It was first detected by ultrasound. For the 29 other patients, exclusion of pneumothorax was confirmed by ultrasound and chest X-ray. No misplacement type complications detected. This was confirmed by ultrasound and radiological exclusions.
Ultrasound is a faster tool than RTX in excluding mechanical complications after CVC placement. It guarantees a non-irradiating examination as efficient as chest X-ray for intensive care patients.
中心静脉导管(CVC)置入术是重症监护中常见的操作。该操作并非没有并发症,长期以来其并发症的诊断依赖于胸部X线检查。目前,超声似乎是一种有趣的替代方法。
报告使用超声对CVC置入术后排除机械性并发症所需时间的影响。
这是一项前瞻性、多中心、对比、双盲研究。纳入决定进行CVC置入的患者。置入后,安排胸部X线检查并进行超声检查以寻找导管误置和气胸的迹象。两项检查由两名不同的医生解读。超声组和胸部X线检查组的主要终点是排除并发症所需时间“T1”。
30例患者纳入本研究。超声检查的平均T1时间显著低于放射学检查的平均T1时间(p = 0.000)。仅观察到1例气胸。首次由超声检测到。对于其他29例患者,超声和胸部X线检查均确认排除气胸。未检测到导管误置类型的并发症。超声和放射学检查均证实了这一点。
在排除CVC置入术后的机械性并发症方面,超声比胸部X线检查更快。它为重症监护患者提供了一种与胸部X线检查同样有效的无辐射检查方法。