Agitated Saline Bubble−Enhanced Ultrasound for Assessing Appropriate Position of Hemodialysis Central Venous Catheter in Critically Ill Patients
نویسندگان
چکیده
APACHE, Acute Physiology and Chronic Health Evaluation; ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment. To the Editor: Renal replacement therapy is recommended to be initiated immediately in patients with life-threatening acute kidney injury (AKI) related symptoms. Ultrasound-guided insertion of hemodialysis catheter is recommended for vascular access. Agitated saline bubble enhanced ultrasound is efficient and rapid to ensure the correct positioning of central venous cateter in critically ill patients. Delayed appearance of microbubbles in the right atrium indicates inadequate positioning. A recent retrospective study performed in 202 patients admitted in a dialysis center and undergoing internal jugular catheterization for hemodialysis or medication administration reported that 2 catheter malpositions were detected immediately by agitated saline bubble enhanced ultrasound. The primary aim of this prospective study, which was performed in ventilated, critically ill patients with AKI, was to compare agitated saline bubble enhanced ultrasound with bedside chest radiography for the confirmation of appropriate positioning of hemodialysis catheter. The secondary aim was to compare agitated saline bubble enhanced ultrasound and bedside chest radiography completion times.
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