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Though the use of ultrasound (US) is widespread for the placement of central venous catheters (CVCs), its real time use for guiding optimal tip position is not established yet in paediatric population” Kesarkar et al (2019).

Abstract:

Central Venous Cannulation is a crucial skill for an anesthesiologist. To prevent complications like arrhythmias, cardiac perforation, tamponade, etc., it is recommended to position the catheter tip at the superior vena cava – right atrium (SVC-RA) junction. Though the use of ultrasound (US) is widespread for the placement of central venous catheters (CVCs), its real time use for guiding optimal tip position is not established yet in paediatric population. We propose the use of ‘Cascade Sign’ for ultrasonographic confirmation of catheter position.

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Reference:

Kesarkar, N., Kulkarni, K. and Dave, N. (2019) Cascade sign: A guide to sonographic confirmation of central venous catheter position. Paediatric Anaesthesia. June 2nd. doi: 10.1111/pan.13674. [Epub ahead of print].