Standardized Ultrasound Protocol for Peripherally Inserted Central Catheters in Neonates: A Retrospective, X-ray Controlled Observational Study.

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-09-30 DOI:10.3390/children11101204
Oliver Firszt, Magdalena Maślanka, Agata Grabowska, Ewa Kluczewska
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Abstract

Objectives: Ultrasound (US) has been reported to be a reliable imaging modality for locating the tip of peripherally inserted central venous catheters (PICC) in neonates. However, its use requires a certain level of expertise, which may limit its application. Standardization of US examinations using designed protocols may improve their efficiency and ease of use. The objective of our study is to evaluate the effectiveness of introducing a standardized US protocol for PICC guidance. Methods: An expert panel was formed in order to develop a standardized US protocol for PICC assessment. Institutional review board agreement was obtained. This protocol was then used by participating clinicians to assess PICC position. Every assessment was followed by a radiographic control. The study group consisted of 262 US examinations of PICC lines in a level III neonatal intensive care unit (NICU) performed according to the designed protocol. Subsequent statistical analysis was made with the RStudio software, R version 4.3.1 (2023-06-16 ucrt). Results: Compared to the X-ray control, standardized US examinations showed 100% sensitivity, 81% specificity, an accuracy of 98% and a 98% precision for assessing catheter placement. The Cohen's Kappa value for the comparison of X-ray and US studies was 0.88, indicating good agreement between the two methods. Conclusions: Standardized US examinations have shown similar potential for evaluating the location of PICC lines when compared with radiographic studies. Implementing a standardized protocol in the NICU may facilitate the ultrasound assessment of PICC lines and reduce exposure to ionizing radiation.

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新生儿外周置入中心导管的标准化超声方案:一项回顾性 X 射线对照观察研究。
目的:据报道,超声(US)是确定新生儿外周插入中心静脉导管(PICC)尖端位置的可靠成像方式。然而,使用这种方法需要一定的专业知识,这可能会限制其应用。使用设计好的方案对 US 检查进行标准化可提高其效率和易用性。我们的研究旨在评估在 PICC 引导中引入标准化 US 协议的效果。方法:我们成立了一个专家小组,以制定用于 PICC 评估的标准化 US 协议。并获得了机构审查委员会的同意。然后,参与的临床医生使用该方案评估 PICC 位置。每次评估后都会进行射线对照。研究组包括根据设计方案在三级新生儿重症监护病房 (NICU) 对 PICC 管路进行的 262 次 US 检查。随后使用 RStudio 软件(R 版本 4.3.1 (2023-06-16 ucrt))进行统计分析。结果与 X 光对照组相比,标准化 US 检查在评估导管位置方面显示出 100% 的敏感性、81% 的特异性、98% 的准确性和 98% 的精确性。X 射线和 US 研究比较的 Cohen's Kappa 值为 0.88,表明两种方法之间具有良好的一致性。结论:与 X 光检查相比,标准化 US 检查在评估 PICC 管路位置方面具有相似的潜力。在新生儿重症监护室实施标准化方案有助于对 PICC 管路进行超声评估,并减少电离辐射暴露。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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