Journal article
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study
PloS one, Vol.16(3), p.e0248999
03/22/2021
DOI: 10.1371/journal.pone.0248999
PMID: 33750977
Abstract
Background
Delayed identification of infiltration and dysfunction of peripheral intravenous (PIV) access can lead to serious consequences during general anesthesia in children. This preliminary study aimed to describe the application of precordial Doppler ultrasound during general anesthesia in children to detect and confirm the correct PIV access and to evaluate the accuracy of this method.
Methods
This was a single-center, preliminary study that was conducted in children (<18 years) who were scheduled for elective surgeries between October 2019 and March 2020. Rater anesthesiologists judged the change in precordial Doppler sound (S test) before and after injection of 0.5 mL/kg of normal saline (NS) via PIV. Blood flow velocity before and after NS injection was recorded, and multiple cutoff points were set to analyze the accuracy of detecting the infiltration and dysfunction of PIV catheter (V test).
Results
The total incidence of peripheral infiltration and dysfunction of PIV catheter was 7/512 (1.4%). In the S test, the sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver-operating characteristic curves (AUCs) were 5/7 (71.4%; 95% confidence interval [CI], 29.0%-96.3%), 490/505 (97.0%; 95% CI, 95.1%-98.3%), 24.0, 0.29, and 0.84, respectively. The V test showed that the reasonable threshold of blood flow velocity change was 1.0 m/s, with sensitivity, specificity, positive and negative likelihood ratios, and AUC of 4/7 (57.1%; 95% CI, 18.4%-90.1%), 489/505 (96.8%; 95% CI, 94.9%-98.2%), 18.0 and 0.44, and 0.84, respectively.
Conclusions
This preliminary study demonstrated that precordial Doppler ultrasound is a feasible, easy-to-use, and noninvasive technique with good accuracy to confirm the correct PIV access during general anesthesia in children. However, its accuracy requires further evaluation.
Details
- Title: Subtitle
- Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study
- Creators
- Taiki Kojima - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanKana Kitamura - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanShogo Ichiyanagi - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanFumio Watanabe - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanYukiko Yamaguchi - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanEmi Sato - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanDaisuke Tani - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanHiromi Kako - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, JapanAli Kandil - Cincinnati Children's Hospital Medical CenterSachiko Ohde - St. Luke's International UniversityMitsunori Miyazu - Aichi Childrens Hlth & Med Ctr, Dept Anesthesiol, Obu, Aichi, Japan
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.16(3), p.e0248999
- DOI
- 10.1371/journal.pone.0248999
- PMID
- 33750977
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library Science
- Number of pages
- 13
- Language
- English
- Date published
- 03/22/2021
- Academic Unit
- Anesthesia
- Record Identifier
- 9985177942602771
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