Point-of-care ultrasonography for verification of central venous catheter placement in cats and dogs

TL;DR

This study shows that ultrasound can reliably check catheter placement in cats and dogs, avoiding the need for X-rays.

Contribution

The study introduces a reliable ultrasound protocol for verifying central venous catheter placement in small animals.

Findings

Ultrasonography showed 94% agreement with radiography for catheter placement verification.

The bicaval atrial view had high reliability (Kappa = 0.87) for identifying catheter tip location.

Ultrasound is a non-invasive alternative to radiography without ionizing radiation exposure.

Abstract

This prospective study aimed to investigate the use of ultrasonography for verifying central venous catheter placement in hospitalized cats and dogs, in comparison with radiographic assessment.

The investigation was conducted on client-owned animals. The position of the central venous catheter was checked using both thoracic radiography and ultrasonography. Ultrasonographic examination was performed in three steps: two intercostal scans of the cranial thorax (transverse and longitudinal scans), to visualize the course of the cranial vena cava within the mediastinum, and one right parasternal scan (sub-costal bicaval view), to visualize both the cranial and caudal vena cava entering the right atrium.

A total of 15 animals (8 dogs and 7 cats) were included in this study. Radiographic evaluation confirmed correct device placement within the cranial vena cava in 15/15 animals, with catheter extension into the right atrium observed in 8/15 cases. Ultrasonographic assessment of the mediastinal region demonstrated good agreement with radiographic findings (94%; CI95%: 83%−100%), and the bicaval atrial view showed high reliability in identifying central venous catheter tip location (Kappa = 0.87; CI95%: 65%−100%).

Ultrasound appears to be a reliable, non-invasive method for evaluating central venous catheter position in dogs and cats, with diagnostic accuracy comparable to radiography and the advantage of avoiding ionizing radiation exposure.

Figures