Ultrasonic examination - An alternative to chest radiography after centralvenous catheter insertion?

We evaluated ultrasonic examination as a diagnostic tool for catheter mispl acement and pneumothorax after central venous catheter inser, tion. Physici ans in the intensive care unit (ICU) performed the ultrasonic examinations, and the results were compared with those of chest radiography. Eighty-five central venous catheters (70 subclavian and 15 internal jugular) were inse rted into 81 patients, 10 misplacements and one pneumothorax occurred. Ultr asonic examination feasibility was 99.6%. The only pneumothorax and all mis placements except one were diagnosed by ultrasound. Taking into considerati on misplacements and pneumothorax research, ultrasonic examination did not give any false positive results. The mean time of the entire ultrasonic exa mination was 6.8 +/- 3.5 min, whereas 80.3 +/- 66.7 min were needed for the radiography (p < 0.0001). This study has suggested that ultrasonic diagnos is of catheter misplacement and pneumothorax related to central venous cath eterization is a rapid and accurate method that can be easily performed by ICU physicians.