Publication: Diagnostic accuracy of contrast-enhanced ultrasound with dextrose 50% in detecting supradiaphragmatic central venous catheter malposition
| dc.contributor.author | Adanan, Muhammad Suhairi | |
| dc.date.accessioned | 2026-05-11T23:32:32Z | |
| dc.date.available | 2026-05-11T23:32:32Z | |
| dc.date.issued | 2022 | |
| dc.description.abstract | Background: Central venous catheter (CVC) insertion is common in an in-patient medical setting. The usage varies from the administration of drugs, resuscitation, and haemodialysis. A standard practice to confirm CVC placement is by using a chest radiograph. Similarly, the usage of contrast-enhanced ultrasound (CEUS) can also detect catheter malposition, as shown by previous studies. Most studies used saline as a contrast, however it has been observed that using Dextrose 50% (D50%) as a contrast solution instead of saline results in better ultrasonic features. We explored the diagnostic accuracy of using D50% as a contrast solution to detect supradiaphragmatic central venous catheter malposition in Hospital Universiti Sains Malaysia (HUSM). Method: This is a cross-sectional study involving patients who had CVC inserted according to standard indication and clinical practice. Convenient sampling was used, and subjects were screened from in-patient ward HUSM. We compared catheter malposition detection using Rapid Atrial Swirl Sign (RASS) features by CEUS with D50% and central venous catheter tip on chest radiograph. Additionally, we compared the agreement between first and second investigators regarding RASS features. Result: In total, we included 99 patients. Seven catheter malpositions were detected by chest radiograph, and from this, only 1 was detected by CEUS. The sensitivity of detecting catheter malposition by CEUS D50% was 14.3%, and specificity was 95.5%. There was a moderate agreement between ultrasound and chest x-ray film with a Cohen’s Kappa coefficient of 0.533. Conclusion: In this study, CEUS using D50% cannot replace CXR to detect catheter malposition. However, it can determine the correct CVC position in the venous following insertion. | |
| dc.identifier.uri | https://erepo.usm.my/handle/123456789/24171 | |
| dc.language.iso | en | |
| dc.subject | catheter malposition | |
| dc.subject | chest radiograph | |
| dc.title | Diagnostic accuracy of contrast-enhanced ultrasound with dextrose 50% in detecting supradiaphragmatic central venous catheter malposition | |
| dc.type | Resource Types::text::thesis::master thesis | |
| dspace.entity.type | Publication | |
| oairecerif.author.affiliation | Universiti Sains Malaysia |