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01.02.2015 | Original Article

Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in image-guided central venous catheter placement in children weighing less than 10 kg

verfasst von: Roberto Miraglia, Luigi Maruzzelli, Kelvin Cortis, Marcello Piazza, Roberta Gerasia, Simona Maggio, Fabio Tuzzolino, Angelo Luca

Erschienen in: Pediatric Radiology | Ausgabe 2/2015

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Abstract

Background

Ultrasound-guided central venous puncture and fluoroscopic guidance during central venous catheter (CVC) positioning optimizes technical success and lowers the complication rates in children, and is therefore considered standard practice.

Objective

The purpose of this study was to compare the radiation exposure levels recorded during CVC placement in children weighing less than 10 kg in procedures performed using an image intensifier-based angiographic system (IIDS) to those performed in a flat-panel detector-based interventional suite (FPDS).

Materials and methods

A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 children weighing less than 10 kg was performed. Mean age was 8.2 ± 4.4 months (range: 1–22 months). Mean weight was 7.1 ± 2.7 kg (range: 2.5–9.8 kg). The procedures were classified into two categories: non-tunneled and tunneled CVC placement.

Results

Thirty-five procedures were performed with the IIDS (21 non-tunneled CVC, 14 tunneled CVC); 61 procedures were performed with the FPDS (47 non-tunneled CVC, 14 tunneled CVC). For non-tunneled CVC, mean DAP was 113.5 ± 126.7 cGy cm² with the IIDS and 15.9 ± 44.6 cGy · cm² with the FPDS (P < 0.001). For tunneled CVC, mean DAP was 84.6 ± 81.2 cGy · cm² with the IIDS and 37.1 ± 33.5 cGy cm² with the FPDS (P = 0.02).

Conclusion

The use of flat-panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.

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Titel: Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in image-guided central venous catheter placement in children weighing less than 10 kg
verfasst von: Roberto Miraglia
Luigi Maruzzelli
Kelvin Cortis
Marcello Piazza
Roberta Gerasia
Simona Maggio
Fabio Tuzzolino
Angelo Luca
Publikationsdatum: 01.02.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Radiology / Ausgabe 2/2015
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-3119-5

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Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in image-guided central venous catheter placement in children weighing less than 10 kg