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Introduction of precordial Doppler ultrasound to confirm correct peripheral venous access during general anesthesia

Taiki Kojima1, Kana Kitamura1, Shogo Ichiyanagi1

  • 1Department of Anesthesiology, Aichi Children's Health and Medical Center, Aichi, Japan.

Plos One
|March 22, 2021
PubMed

Insights

Precordial Doppler ultrasound accurately confirms peripheral intravenous (PIV) access in children during general anesthesia, aiding in early detection of PIV dysfunction and infiltration.

Area of Science:

  • Pediatric Anesthesiology
  • Medical Ultrasound
  • Vascular Access

Background:

  • Delayed identification of peripheral intravenous (PIV) access issues can cause serious complications in pediatric general anesthesia.
  • This study addresses the need for accurate PIV assessment in children.

Purpose of the Study:

  • To describe the application of precordial Doppler ultrasound for detecting and confirming correct PIV access in children undergoing general anesthesia.
  • To evaluate the accuracy of precordial Doppler ultrasound in identifying PIV infiltration and dysfunction.

Main Methods:

  • A single-center preliminary study involving children (<18 years) scheduled for elective surgery.
  • Anesthesiologists assessed changes in precordial Doppler sound (S test) and blood flow velocity (V test) after saline injection via PIV.
  • Sensitivity, specificity, likelihood ratios, and AUC were calculated to determine accuracy.

Main Results:

  • The incidence of PIV infiltration/dysfunction was 1.4% (7/512).
  • The S test showed 71.4% sensitivity and 97.0% specificity (AUC 0.84).
  • The V test (threshold 1.0 m/s) demonstrated 57.1% sensitivity and 96.8% specificity (AUC 0.84).

Conclusions:

  • Precordial Doppler ultrasound is a feasible, noninvasive method for confirming PIV access in pediatric anesthesia.
  • The technique shows good accuracy in detecting PIV issues.
  • Further evaluation is needed to confirm its diagnostic performance.
Abstract

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