Utilidad de la ecografía para la determinación del adecuado posicionamiento de la punta del cateter venoso central en pacientes pediatrícos
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Tradicionalmente se ha determinado el adecuado posicionamiento de los catéteres venosos centrales de inserción periférica en pacientes pediátricos mediante radiografía de tórax, exponiéndolos a radiaciones ionizantes. Estudios extranjeros valoraron el posicionamiento de estos catéteres en niños mediante ecografía con buenos resultados. No se conocen estudios similares en Ecuador. Objetivos: evaluar pacientes pediátricos portadores de catéteres venosos centrales mediante ecografía, determinar el adecuado posicionamiento de la punta del catéter venoso central mediante el uso de la ecografía, comparar los resultados obtenidos mediante la ecografía con los obtenidos mediante la radiografía de tórax. Estudio de investigación no experimental, retrospectivo y descriptivo, de cohorte transversal, realizado en el Instituto Oncológico Nacional “Juan Tanca Marengo”, entre agosto de 2014 hasta enero de 2015, en pacientes menores de 18 años, portadores de un catéter venoso central temporal o permanente, colocado mediante vía subclavia o yugular interna. Resultados: se evaluaron 76 pacientes mediante ecografía, se determinó el adecuado posicionamiento de la punta del catéter venoso central en 76 casos (100%) mediante el uso de la ecografía; fue posible comparar los resultados obtenidos mediante la ecografía con los obtenidos mediante la radiografía de tórax, registrando un 6,6% de falsos negativos para la radiografía versus la ecografía con la que se visualizó directamente la punta del catéter en la luz de la vena cava en el 100% de pacientes (p=0.025; p<0.05); se demostró que la ecografía es un método útil y seguro para la determinación del adecuado posicionamiento de la punta del catéter venoso central en pacientes pediátricos.
Traditionally it has been determined the proper positioning of central venous catheters peripherally inserted in pediatric patients with chest radiography, exposing them to ionizing radiation. Foreign studies assessed the positioning of these ultrasound catheters in children with good results. No similar studies are known in Ecuador. Objectives: To evaluate pediatric patients carriers of central venous catheters with ultrasound, determine the appropriate positioning of the tip of central venous catheter using ultrasound, compare the results obtained by ultrasound with those obtained by chest radiograph. Study of non-experimental, retrospective and descriptive research, crosscohort, conducted in the Oncology National "Juan Tanca Marengo" Institute, from August 2014 to January 2015, in patients under 18, holders of a temporary central venous catheter or permanent, placed by internal jugular or subclavian route. Results: 76 patients were evaluated by ultrasound, proper positioning of the tip of central venous catheter in 76 cases (100%) by using ultrasound was determined; It was possible to compare the results obtained by ultrasound with those obtained by chest X-ray, recording a 6.6% false negatives for radiography versus ultrasonography which was directly visualized the catheter tip in the light of the vena cava in 100% of patients (p = 0.025; p <0.05); It showed that ultrasound is a safe and useful method for determining the proper positioning of the tip of central venous catheter in pediatric patients
Traditionally it has been determined the proper positioning of central venous catheters peripherally inserted in pediatric patients with chest radiography, exposing them to ionizing radiation. Foreign studies assessed the positioning of these ultrasound catheters in children with good results. No similar studies are known in Ecuador. Objectives: To evaluate pediatric patients carriers of central venous catheters with ultrasound, determine the appropriate positioning of the tip of central venous catheter using ultrasound, compare the results obtained by ultrasound with those obtained by chest radiograph. Study of non-experimental, retrospective and descriptive research, crosscohort, conducted in the Oncology National "Juan Tanca Marengo" Institute, from August 2014 to January 2015, in patients under 18, holders of a temporary central venous catheter or permanent, placed by internal jugular or subclavian route. Results: 76 patients were evaluated by ultrasound, proper positioning of the tip of central venous catheter in 76 cases (100%) by using ultrasound was determined; It was possible to compare the results obtained by ultrasound with those obtained by chest X-ray, recording a 6.6% false negatives for radiography versus ultrasonography which was directly visualized the catheter tip in the light of the vena cava in 100% of patients (p = 0.025; p <0.05); It showed that ultrasound is a safe and useful method for determining the proper positioning of the tip of central venous catheter in pediatric patients
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Catéter, Ultrasonografía, Pediatría, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador, Cateterismo venoso central