Umbilikal Venöz Kateter Pozisyonunun Değerlendirilmesinde Direkt Grafi ile Ultrasonografinin Karşılaştırılması
Abstract
Amaç: Çalışmada umbilikal venöz kateter pozisyonunun belirlenmesinde rutin olarak kullanılan direkt radyografi ile radyasyon içermeyen bir yöntem olan ultrasonografinin karşılaştırılması amaçlanmıştır.Gereç ve Yöntemler: Mart-Temmuz 2016 tarihleri arasında umbilikal venöz kateter takılmış ve kateter takılı iken, farklı nedenlerle abdominal ultrasonografi yapılmış 20 bebeğin ultrasonografi ve direkt radyografi incelemeleri retrospektif olarak değerlendirilmiştir. Kateter seyri ve ucunun sonlanma düzeyi her iki teknikle ayrı ayrı incelenmiştir.Bulgular: Direkt grafide torakal vertebralar temel alındığında, kateter uçlarının %60’ı T8-T10 aralığında sonlanmakta iken, %40’I T11-T12 düzeyleri arasında inferior konumluydu ve karaciğer içerisindeki vasküler yapılarda sonlanmaktaydı. Direkt grafide sağ hemidiyafragma seviyesi temel alındığında, kateter uçları hastaların %65’inde sağ hemidiyafragmanın altında iken, %35’inde sağ hemidiyafragma düzeyinde sonlanmaktaydı. Ultrasonografi bulgularına göre kateterlerin %30’i suprahepatik inferior vena kavada, geriye kalan %70’i karaciğer içerisinde bir vasküler yapıda sonlanmaktaydı. Ayrıca, ultrasonografi ile iki olguda sol portal ven trombozu ve bir olguda karaciğerde parankimal hematom olmak üzere toplam üç hastada kateter ile ilişkili komplikasyon saptandı.Sonuç: Ultrasonografi umbilikal venöz kateterlerin seyri ve uçlarının anatomik sonlanma noktalarını net olarak ortaya koyabilmekte, komplikasyonları saptamada daha üstün görülmektedir. Bu nedenle radyografiye alternatif bir teknik olup yenidoğan yoğun bakım ünitelerinde yaygın olarak kullanılabilir.
References
- Haase R, Hein M, Thale V, Vilser C, Merkel N. Umbilical venous catheters – analysis of malpositioning over a 10-year period. Z Geburtshilfe Neonatol 2011;215:18-22.
- Hermansen MC, Hermansen MG. Intravascular catheter complications in the neonatal intensive care unit. Clin Perinatol 2005;32:141-56.
Comparison of Direct Radiography and Ultrasonography for the Evaluation of the Umbilical Venous Catheter Position
Abstract
Objective: To determine the umbilical venous catheter position by ultrasound and radiography, and to compare these two techniques.Material and Methods: We retrospectively evaluated the abdominal ultrasound and direct radiography of 20 umbilical venous catheters placed in neonates between March and July 2016. The location of the catheter tips was noted in both techniques. Results: According to direct radiography, the tips of the catheters terminated at the T8-T10 level in 60% of the cases. Whereas, in the remaining 40% of the cases, the tips of the catheters terminated inferiorly at the T11-T12 level. When we consider the tip of the catheter according to the level of right hemidiaphragm on the radiograph, the catheter tips of 35% of the cases terminated at the level of the right hemidiaphragm, while 65% were below the level of the right hemidiaphragm. On ultrasound, the tips of the catheters terminated at the suprahepatic inferior vena cava in 30% of the cases, whereas, the remaining 70% terminated inferiorly and were located in the liver. Furthermore, ultrasound revealed catheter complications in three cases.Conclusion: Ultrasonography seems a reliable technique for the determination of the umbilical venous catheter tip and its position and may be an alternative to direct radiography
References
- Haase R, Hein M, Thale V, Vilser C, Merkel N. Umbilical venous catheters – analysis of malpositioning over a 10-year period. Z Geburtshilfe Neonatol 2011;215:18-22.
- Hermansen MC, Hermansen MG. Intravascular catheter complications in the neonatal intensive care unit. Clin Perinatol 2005;32:141-56.
Details
| Other ID | JA34KK44VC |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 1, 2018 |
| Submission Date | December 1, 2018 |
| Published in Issue | Year 2018 Volume: 12 Issue: 3 |
The publication language of Turkish Journal of Pediatric Disease is English.
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