We are grateful for the comments of Vezzali et al, [
[1]
] and we agree with them that a combined method of B-mode and contrast enhanced ultrasonography
(CEUS) would help identify the correct position of the Central venous line (CVL) tip.
In our study, we checked in B-mode the Seldinger during canulation and before dilatation
of the vessel (to avoid complication), and we believe it is also important to check
omo- and controlateral neck veins after CVL insertion to identify intravascular malpositioning.
Regarding ultrasound evaluation of the tip position of the CVL in the intrathoracic
vessels using B-mode, we can see the tip in the neck veins and only few centimeters
before the entrance of superior vena cava (SVC) in right atrium (this means that the
tip might be anywhere distal the brachiocephalic vein); in our study, CEUS could not
differentiate the malpositioning of CVL in brachiocefalic vein as the delay of appearance
compared with correct positioning in SVC is not detectable with visual extimation
time of bubble appearance in right atrium (RA).- Vezzani A.
- Brusasco C.
- Corradi F.
Contrast-enhanced ultrasound to determine correct central venous catheter position.
Am J Emerg Med. 2014 Feb 4; (pii: S0735-6757(14)00063-1. [Epub ahead of print])https://doi.org/10.1016/j.ajem.2014.01.033
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Reference
- Contrast-enhanced ultrasound to determine correct central venous catheter position.Am J Emerg Med. 2014 Feb 4; (pii: S0735-6757(14)00063-1. [Epub ahead of print])https://doi.org/10.1016/j.ajem.2014.01.033
Article Info
Publication History
Published online: March 21, 2014
Identification
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
