Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study.
<h4>Background</h4>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 genera...
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2021-01-01
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doaj-3ffca70611c043f99a860d0d49aff41e2021-04-06T04:30:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024899910.1371/journal.pone.0248999Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study.Taiki KojimaKana KitamuraShogo IchiyanagiFumio WatanabeYukiko YamaguchiEmi SatoDaisuke TaniHiromi KakoAli I KandilSachiko OhdeMitsunori Miyazu<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0248999 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Taiki Kojima Kana Kitamura Shogo Ichiyanagi Fumio Watanabe Yukiko Yamaguchi Emi Sato Daisuke Tani Hiromi Kako Ali I Kandil Sachiko Ohde Mitsunori Miyazu |
spellingShingle |
Taiki Kojima Kana Kitamura Shogo Ichiyanagi Fumio Watanabe Yukiko Yamaguchi Emi Sato Daisuke Tani Hiromi Kako Ali I Kandil Sachiko Ohde Mitsunori Miyazu Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. PLoS ONE |
author_facet |
Taiki Kojima Kana Kitamura Shogo Ichiyanagi Fumio Watanabe Yukiko Yamaguchi Emi Sato Daisuke Tani Hiromi Kako Ali I Kandil Sachiko Ohde Mitsunori Miyazu |
author_sort |
Taiki Kojima |
title |
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. |
title_short |
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. |
title_full |
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. |
title_fullStr |
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. |
title_full_unstemmed |
Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: A preliminary study. |
title_sort |
introduction of precordial doppler ultrasound to confirm correct peripheral venous access during general anesthesia in children: a preliminary study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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. |
url |
https://doi.org/10.1371/journal.pone.0248999 |
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