CEUS works well for central-line check, less so for ruling out misplacement

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Contrast-enhanced ultrasound (CEUS) imaging is safe, efficient and highly specific for confirming location and placement of central venous catheter tips in adult patients, according to a medical literature meta-analysis running in the December edition of the Journal of Ultrasound in Medicine.

Ralph Bou Chebl, MD, and colleagues at the American University of Beirut Medical Center in Lebanon reviewed more than 2,200 peer-reviewed research articles dealing with patients receiving internal jugular or subclavian central venous catheters in the emergency department or ICU.

To meet the inclusion criteria, the catheter tip location had to be checked with the use of agitated saline CEUS technique.

The team found the CEUS approach yielded a positive predictive value of 92.1 percent and a negative predictive value of 98.5 percent for confirming the placement of central venous catheters.

At the same time, however, CEUS had sensitivity of just 72 percent for ruling out misplacement, prompting the authors to recommend the use of chest radiography whenever misplacement is suspected.

The journal has posted the study in full for free.