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Agitated saline contrast to delineate central venous catheter position in neonates

Journal of Perinatology volume 41, pages 1638–1644 (2021)Cite this article

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Abstract

Objective

Central venous catheter (CVC) insertion is required for the management of sick neonates. Ultrasonography/targeted neonatal echocardiography (TNE) with/without normal saline (NS) flush is used to identify CVC position. The present study compared the visibility and safety of agitated saline (AS) with normal saline (NS) flush.

Study design

This prospective interventional study included 110 CVC insertions, both umbilical venous catheterization (UVC) and peripherally inserted central catheterization (PICC). Catheter position was monitored by real-time TNE.

Results

Overall visibility of catheter tip (combined UVC and PICC) was significantly better in AS (n = 55) compared with NS group (n = 55) [48/55 (87.2%) vs. 28/55 (50.9%); p < 0.0001]. Time to detect catheter tip by AS push was significantly less than that of NS push. There was no difference in the amount of saline flush required with either method. No major adverse effect was observed.

Conclusions

AS push can be used as a safe method to delineate CVC position in neonates.

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Author contributions

JU, SB, YS, and PS conceptualized and designed the study, coordinated and supervised data collection, drafted the initial manuscript, and reviewed and revised the manuscript. KCD, SS, and RG performed the procedures, collected data, carried out the initial analyses, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, India

    Jaya Upadhyay, Sriparna Basu, Kanhu Charan Digal, Shantanu Shubham, Rajat Grover & Poonam Singh

  2. Division of Cardiology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India

    Yash Srivastava

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  1. Jaya Upadhyay
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  2. Sriparna Basu
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  3. Yash Srivastava
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  4. Kanhu Charan Digal
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  6. Rajat Grover
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  7. Poonam Singh
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Corresponding author

Correspondence to Sriparna Basu.

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Upadhyay, J., Basu, S., Srivastava, Y. et al. Agitated saline contrast to delineate central venous catheter position in neonates. J Perinatol 41, 1638–1644 (2021). https://doi.org/10.1038/s41372-020-0761-7

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