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Use of Contrast‐Enhanced Ultrasound for Confirmation of Central Venous Catheter Placement: Systematic Review and Meta‐analysis
Author(s) -
Bou Chebl Ralph,
Kiblawi Shafeek,
El Khuri Christopher,
El Hajj Nadine,
Bachir Rana,
Aoun Roni,
Abou Dagher Gilbert
Publication year - 2017
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14296
Subject(s) - medicine , meta analysis , catheter , confidence interval , radiology , radiography , ultrasound , central venous catheter , predictive value , intensive care unit
Objectives The purpose of this meta‐analysis was to determine the sensitivity, specificity, and positive and negative predictive values of contrast‐enhanced ultrasound (US) for confirming the tip location and placement of central venous catheters in adult patients. Methods A systematic review was performed using electronic databases, including MEDLINE, ClinicalTrials.gov , Cochrane, Embase, PubMed, and Scopus. Inclusion criteria were studies conducted on adult patients receiving an internal jugular or a subclavian central venous catheter in the emergency department or intensive care unit. Furthermore, the catheter tip location had to be checked with the use of the agitated saline contrast‐enhanced US technique. Results A total of 2245 articles were screened by title and abstract. Seventeen articles were retrieved and assessed for the predefined inclusion criteria. Four articles and 1 abstract were used in the final analysis. Contrast‐enhanced US showed pooled sensitivity of 72% (95% confidence interval, 44%–91%), pooled specificity of 100% (95% confidence interval, 99%–100%), a positive predictive value of 92.1%, and a negative predictive value of 98.5% compared with chest radiography for confirming the placement of central venous catheters. Conclusions In the setting of central venous catheter placement, postprocedural contrast‐enhanced US imaging is a safe, efficient, and highly specific confirmatory test for the catheter tip location compared with chest radiography.