Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients
Abstract Background Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed i...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-01-01
|
| Series: | The Ultrasound Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13089-021-00252-4 |
| _version_ | 1819006829904003072 |
|---|---|
| author | Ana Luisa Silveira Vieira José Muniz Pazeli Júnior Andrea Silva Matos Andreza Marques Pereira Izadora Rezende Pinto Letícia Esteves de Oliveira Silva Letícia Siqueira Guilherme Sofia Laura Archângelo e Silva |
| author_facet | Ana Luisa Silveira Vieira José Muniz Pazeli Júnior Andrea Silva Matos Andreza Marques Pereira Izadora Rezende Pinto Letícia Esteves de Oliveira Silva Letícia Siqueira Guilherme Sofia Laura Archângelo e Silva |
| author_sort | Ana Luisa Silveira Vieira |
| collection | DOAJ |
| description | Abstract Background Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed in the routine practice. The aim of this study was to investigate if a compression technique for the diagnosis of TR-CVCd blindly performed by PoCUS experts and medical students is accurate when compared to a Doppler study. Methods Two medical students without prior knowledge in PoCUS received a short theoretical–practical training to evaluate TR-CVCd of the internal jugular vein by means of the ultrasound compression technique. After the training phase, patients with central venous catheter for dialysis (CVCd) were evaluated by the students in a private hemodialysis clinic. The results were compared to those obtained on the same population by doctors with solid experience in PoCUS, using both the compression technique and the color Doppler. Results Eighty-one patients were eligible for the study and the prevalence of TR-CVCd diagnosed by Doppler was 28.4%. The compression technique performed by the students and by experts presented, respectively, a sensitivity of 59.2% (CI 51.6–66.8) vs 100% and a specificity of 89.6% (CI 84.9–94.3) vs 94.8% (CI 91.4–98.2). Conclusion The compression technique in the hands of PoCUS experts demonstrated high accuracy in the diagnosis of TR-CVCd and should represent a standard in the routine examination of dialytic patients. The training of PoCUS inexperienced students for the diagnosis of TR-CVCd is feasible but did not lead to a sufficient level of sensitivity. |
| first_indexed | 2024-12-21T00:14:55Z |
| format | Article |
| id | doaj.art-c204ba06ceb64169b97442018eb44415 |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-12-21T00:14:55Z |
| publishDate | 2022-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-c204ba06ceb64169b97442018eb444152022-12-21T19:22:16ZengSpringerOpenThe Ultrasound Journal2524-89872022-01-011411610.1186/s13089-021-00252-4Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patientsAna Luisa Silveira Vieira0José Muniz Pazeli Júnior1Andrea Silva Matos2Andreza Marques Pereira3Izadora Rezende Pinto4Letícia Esteves de Oliveira Silva5Letícia Siqueira Guilherme6Sofia Laura Archângelo e Silva7Department of Point of Care Ultrasound, Barbacena Medical SchoolDepartment of Point of Care Ultrasound, Barbacena Medical SchoolDepartment of Nephrology, Santa Casa de Misericórdia de BarbacenaBarbacena Medical SchoolBarbacena Medical SchoolBarbacena Medical SchoolBarbacena Medical SchoolBarbacena Medical SchoolAbstract Background Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed in the routine practice. The aim of this study was to investigate if a compression technique for the diagnosis of TR-CVCd blindly performed by PoCUS experts and medical students is accurate when compared to a Doppler study. Methods Two medical students without prior knowledge in PoCUS received a short theoretical–practical training to evaluate TR-CVCd of the internal jugular vein by means of the ultrasound compression technique. After the training phase, patients with central venous catheter for dialysis (CVCd) were evaluated by the students in a private hemodialysis clinic. The results were compared to those obtained on the same population by doctors with solid experience in PoCUS, using both the compression technique and the color Doppler. Results Eighty-one patients were eligible for the study and the prevalence of TR-CVCd diagnosed by Doppler was 28.4%. The compression technique performed by the students and by experts presented, respectively, a sensitivity of 59.2% (CI 51.6–66.8) vs 100% and a specificity of 89.6% (CI 84.9–94.3) vs 94.8% (CI 91.4–98.2). Conclusion The compression technique in the hands of PoCUS experts demonstrated high accuracy in the diagnosis of TR-CVCd and should represent a standard in the routine examination of dialytic patients. The training of PoCUS inexperienced students for the diagnosis of TR-CVCd is feasible but did not lead to a sufficient level of sensitivity.https://doi.org/10.1186/s13089-021-00252-4Venous thrombosisHemodialysisUltrasonographyPoCUSMedical studentsTraining |
| spellingShingle | Ana Luisa Silveira Vieira José Muniz Pazeli Júnior Andrea Silva Matos Andreza Marques Pereira Izadora Rezende Pinto Letícia Esteves de Oliveira Silva Letícia Siqueira Guilherme Sofia Laura Archângelo e Silva Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients The Ultrasound Journal Venous thrombosis Hemodialysis Ultrasonography PoCUS Medical students Training |
| title | Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| title_full | Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| title_fullStr | Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| title_full_unstemmed | Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| title_short | Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| title_sort | ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients |
| topic | Venous thrombosis Hemodialysis Ultrasonography PoCUS Medical students Training |
| url | https://doi.org/10.1186/s13089-021-00252-4 |
| work_keys_str_mv | AT analuisasilveiravieira ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT josemunizpazelijunior ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT andreasilvamatos ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT andrezamarquespereira ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT izadorarezendepinto ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT leticiaestevesdeoliveirasilva ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT leticiasiqueiraguilherme ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients AT sofialauraarchangeloesilva ultrasonographicevaluationofdeepveinthrombosisrelatedtothecentralcatheterinhemodialyticpatients |