Skip to main content

Ultrasound-Guided Procedures Beyond Vascular Access

  • Chapter
  • First Online:
Point-of-Care Ultrasound for the Neonatal and Pediatric Intensivist
  • 496 Accesses

Abstract

Ultrasound-guided vascular access procedures have emerged as the standard of practice across many clinical settings. Ultrasound use by pediatric acute care providers now extends to many other commonly performed bedside procedures. Growing literature supports improved procedural success as well as reduced failure rates, need for multiple attempts, and overall lower complications rate when ultrasound technology is utilized in nonvascular access procedural applications. This chapter explores many nonvascular access procedural applications in which ultrasound is utilized in the acute care setting and describes methods by which to optimize clinical performance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Nigrovic LE, Kuppermann N, Neuman MI. Risk factors for traumatic or unsuccessful lumbar punctures in children. Ann Emerg Med. 2007;49:762–71.

    Article  PubMed  Google Scholar 

  2. Shah KH, Richard KM, Nicholas S, Edlow JA. Incidence of traumatic lumbar puncture. Acad Emerg Med. 2003;10(2):151–4.

    Article  PubMed  Google Scholar 

  3. Glatstein MM, Zucker-Toledano M, Arik A, et al. Incidence of traumatic lumbar puncture: experience of a large, tertiary care pediatric hospital. Clin Pediatr. 2011;50:1005–9.

    Article  Google Scholar 

  4. Pingree EW, Kimia AA, Nigrovic LE. The effect of traumatic lumbar puncture on hospitalization rate for febrile infants 28 to 60 days of age. Acad Emerg Med. 2015;22:240–3.

    Article  PubMed  Google Scholar 

  5. Olowoyeye A, Fadahunsi O, Okudo J, Opaneye O, Okwundu C. Ultrasound imaging versus palpation method for diagnostic lumbar puncture in neonates and infants: a systematic review and meta-analysis. BMJ Paediatr Open. 2019;3(1):e000412.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Neal JT, Kaplan SL, Woodford AL, et al. The effect of bedside ultrasonographic skin marking on infant lumbar puncture success: a randomized controlled trial. Ann Emerg Med. 2017;69:610–619.e1.

    Article  PubMed  Google Scholar 

  7. Özdamar E, Özkaya AK, Güler E, Cantay B, Karabel N, Göksügür Y, Çetinkaya A, Emre Ö. Ultrasound-assisted lumbar puncture in pediatric emergency department. Pediatr Emerg Care. 2017;33(8):e21–3.

    Article  PubMed  Google Scholar 

  8. Gorn M, Kunkov S, Crain EF. Prospective investigation of a novel ultrasound-assisted lumbar puncture technique on infants in the pediatric emergency department. Acad Emerg Med. 2017;24:6–12.

    Article  PubMed  Google Scholar 

  9. Fraga MV, Stoller JZ, Glau CL, et al. Seeing in believing: ultrasound in pediatric procedural performance. Pediatrics. 2019;144(5):e20191401.

    Article  PubMed  Google Scholar 

  10. Gottlieb M, Holladay D, Peksa GD. Ultrasound-assisted lumbar punctures: a systematic review and meta-analysis. Acad Emerg Med. 2019;26(1):85–96.

    Article  PubMed  Google Scholar 

  11. Coley BD, Shiels WE II, Hogan MJ. Diagnostic and interventional ultrasonography in neonatal and infant lumbar puncture. Pediatr Radiol. 2001;31(6):399–402.

    Article  CAS  PubMed  Google Scholar 

  12. Oulego-Erroz I, Mora-Matilla M, AlonsoQuintela P, et al. Ultrasound evaluation of lumbar spine anatomy in newborn infants: implications for optimal performance of lumbar puncture. J Pediatr. 2014;165(4):862–865.e1.

    Article  PubMed  Google Scholar 

  13. Furness G, Reilly MP, Kuchi S. An evaluation of ultrasound imaging for identification of lumbar intervertebral level. Anaesthesia. 2002;57(3):277–80.

    Article  CAS  PubMed  Google Scholar 

  14. Muthusami P, Robinson AJ, Shroff MM. Ultrasound guidance for difficult lumbar puncture in children: pearls and pitfalls. Pediatr Radiol. 2017;47:822–30.

    Article  PubMed  Google Scholar 

  15. Kessler D, Pahalyants V, Kriger J, et al. Preprocedural ultrasound for infant lumbar puncture: a randomized clinical trial. Acad Emerg Med. 2018;25:1027–34.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Abo A, Yamamoto LG, Itoman EM, et al. Positioning for lumbar puncture in children evaluated by bedside ultrasound. Pediatrics. 2010;125:e1149–53.

    Article  PubMed  Google Scholar 

  17. Cashen K, Petersen TL. Pleural effusions and Pneumothoraces. Pediatr Rev. 2017;38(4):170–81.

    Article  PubMed  Google Scholar 

  18. Bhatia R, Davis PG, Doyle LW, Wong C, Morley CJ. Identification of pneumothorax in very preterm infants. J Pediatr. 2011;159(1):115–120.e1.

    Article  PubMed  Google Scholar 

  19. Dotson K, Johnson LH. Pediatric spontaneous pneumothorax. Pediatr Emerg Care. 2012;28(7):715–20.

    Article  PubMed  Google Scholar 

  20. Lichtenstein DA. Ultrasound examination of the lungs in the intensive care unit. Pediatr Crit Care Med. 2009;10(6):693–8.

    Article  PubMed  Google Scholar 

  21. Ebrahimi A, Yousefifard M, Mohammad Kazemi H, Rasouli HR, Asady H, Moghadas Jafari A, Hosseini M. Diagnostic accuracy of chest ultrasonography versus chest radiography for identification of pneumothorax: a systematic review and meta-analysis. Tanaffos. 2014;13(4):29–40.

    PubMed  PubMed Central  Google Scholar 

  22. Islam S, Calkins CM, Goldin AB, Chen C, Downard CD, Huang EY, Cassidy L, Saito J, Blakely ML, Rangel SJ, Arca MJ, Abdullah F, St Peter SD, APSA Outcomes and Clinical Trials Committee, 2011–2012. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg. 2012;47(11):2101–10.

    Article  PubMed  Google Scholar 

  23. Gordon CE, et al. Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med. 2010;170(4):332–9.

    Article  PubMed  Google Scholar 

  24. Raptopoulos V, Davis LM, Lee G, Umali C, Lew R, Irwin RS. Factors affecting the development of pneumothorax associated with thoracentesis. AJR Am J Roentgenol. 1991;156(5):917–20.

    Article  CAS  PubMed  Google Scholar 

  25. Mercaldi CJ, Lanes SF. Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest. 2013;143(2):532–8.

    Article  PubMed  Google Scholar 

  26. Balfour-Lynn IM, Abrahamson E, Cohen G, Hartley J, King S, Parikh D, Spencer D, Thomson AH, Urquhart D, Paediatric Pleural Diseases Subcommittee of the BTS Standards of Care Committee. BTS guidelines for the management of pleural infection in children. Thorax. 2005;60 Suppl 1(Suppl 1):i1–i21.

    Article  CAS  PubMed  Google Scholar 

  27. Hassan M, Rizk R, Essam H, Abouelnour A. Validation of equations for pleural effusion volume estimation by ultrasonography. J Ultrasound. 2017;20(4):267–71.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Havelock T, Teoh R, Laws D, Gleeson F, BTS Pleural Disease Guideline Group. Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65 Suppl 2:ii61–76.

    Article  PubMed  Google Scholar 

  29. Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care. 2014;20(3):315–22.

    Article  PubMed  Google Scholar 

  30. Dancel R, Schnobrich D, Puri N, Franco-Sadud R, Cho J, Grikis L, Lucas BP, El-Barbary M, Society of Hospital Medicine Point of Care Ultrasound Task Force, Soni NJ. Recommendations on the use of ultrasound guidance for adult thoracentesis: a position statement of the Society of Hospital Medicine. J Hosp Med. 2018;13(2):126–35.

    Article  PubMed  Google Scholar 

  31. Bass C, Morris A. UW WISH. Thoracic ultrasonography for bedside thoracentesis [Video]. YouTube. 2019. https://youtube.com/lUAn_1R7V3E.

  32. Josephson T, Nordenskjold CA, Larsson J, Rosenberg LU, Kaijser M. Amount drained at ultrasound-guided thoracentesis and risk of pneumothorax. Acta Radiol. 2009;50(1):42–7.

    Article  CAS  PubMed  Google Scholar 

  33. Raimondi F, Rodriguez Fanjul J, Aversa S, Chirico G, Yousef N, De Luca D, Corsini I, Dani C, Grappone L, Orfeo L, Migliaro F, Vallone G, Capasso L, Lung Ultrasound in the Crashing Infant (LUCI) Protocol Study Group. Lung ultrasound for diagnosing pneumothorax in the critically ill neonate. J Pediatr. 2016;175:74–78.e1.

    Article  PubMed  Google Scholar 

  34. Liu J, Chi JH, Ren XL, Li J, Chen YJ, Lu ZL, Liu Y, Fu W, Xia RM. Lung ultrasonography to diagnose pneumothorax of the newborn. Am J Emerg Med. 2017;35(9):1298–302.

    Article  PubMed  Google Scholar 

  35. Tsang TS, Oh JK, Seward JB. Diagnosis and management of cardiac tamponade in the era of echocardiography. Clin Cardiol. 1999;22(7):446–52.

    Article  CAS  PubMed  Google Scholar 

  36. Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J. 2013;34(16):1186–97.

    Article  PubMed  Google Scholar 

  37. Tsang TS, Oh JK, Seward JB, Tajik AJ. Diagnostic value of echocardiography in cardiac tamponade. Herz. 2000;25(8):734–40.

    Article  CAS  PubMed  Google Scholar 

  38. Alerhand S, Carter JM. What echocardiographic findings suggest a pericardial effusion is causing tamponade? Am J Emerg Med. 2019;37(2):321–6.

    Article  PubMed  Google Scholar 

  39. Adler Y, Charron P, Imazio M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: the task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) endorsed by the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36:2921–64.

    Article  PubMed  Google Scholar 

  40. Tsang TS, Enriquez-Sarano M, Freeman WK, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77:429–36.

    Article  PubMed  Google Scholar 

  41. Tsang TS, El-Najdawi EK, Seward JB, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic experience, 1979–1998. Chest. 1999;116:322–31.

    Article  CAS  PubMed  Google Scholar 

  42. Wong B, Murphy J, Chang CJ, et al. The risk of pericardiocentesis. Am J Cardiol. 1979;44:1110–4.

    Article  CAS  PubMed  Google Scholar 

  43. Maggiolini S, Gentile G, Farina A, et al. Safety, efficacy, and complications of pericardiocentesis by real-time echo-monitored procedure. Am J Cardiol. 2016;117:1369–74.

    Article  PubMed  Google Scholar 

  44. Akyuz S, Zengin A, Arugaslan E, et al. Echo-guided pericardiocentesis in patients with clinically significant pericardial effusion. Outcomes over a 10-year period. Herz. 2015;40(suppl2):153–9.

    Article  PubMed  Google Scholar 

  45. Tsang TS, El-Najdawi EK, Seward JB, et al. Percutaneous echocardiographically guided pericardiocentesis in pediatric patients: evaluation of safety and efficacy. J Am Soc Echocardiogr. 1998;11:1072–7.

    Article  CAS  PubMed  Google Scholar 

  46. Law MA, Borasino S, Kalra Y, et al. Novel, long-axis in-plane ultrasound-guided pericardiocentesis for postoperative pericardial effusion drainage. Pediatr Cardiol. 2016;37:1328–33.

    Article  PubMed  Google Scholar 

  47. Flint N, Siegel RJ. Echo-guided pericardiocentesis: when and how should it be performed? Curr Cardiol Rep. 2020;22:71.

    Article  PubMed  Google Scholar 

  48. Callahan JA, Seward JB. Pericardiocentesis guided by two-dimensional echocardiography. Echocardiography. 1997;14:497–504.

    Article  PubMed  Google Scholar 

  49. Cho BC, Kang SM, Kim DH, et al. Clinical and echocardiographic characteristics of pericardial effusion in patients who underwent echocardiographically guided pericardiocentesis: Yonsei Cardiovascular Center experience, 1993-2003. Yonsei Med J. 2004;45:462–8.

    Article  PubMed  Google Scholar 

  50. Hanaki Y, Kamiya H, Todoroki H, et al. New two-dimensional, echocardiographically directed pericardiocentesis in cardiac tamponade. Crit Care Med. 1990;18:750–3.

    Article  CAS  PubMed  Google Scholar 

  51. Molkara D, Tejman-Yarden S, El-Said H, et al. Pericardiocentesis of noncircumferential effusions using nonstandard catheter entry sites guided by echocardiography and fluoroscopy. Congen Heart Dis. 2011;6:461–5.

    Article  Google Scholar 

  52. De Carlini CC, Maggiolini S. Pericardiocentesis in cardiac tamponade: indications and practical aspects. E-journal Cardiol Pract. 2017;15(19). https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Pericardiocentesis-in-cardiac-tamponade-indications-and-practical-aspects.

  53. Giefer MJ, Murray KF, Colletti RB. Pathophysiology, diagnosis, and management of pediatric ascites. J Pediatr Gastroenterol Nutr. 2011;52:503–13.

    Article  PubMed  Google Scholar 

  54. Kramer RE, Sokol RJ, Yerushalmi B, et al. Large-volume paracentesis in the management of ascites in children. J Pediatr Gastroenterol Nutr. 2001;33:245–9.

    CAS  PubMed  Google Scholar 

  55. Runyon BA. Paracentesis of ascitic fluid: a safe procedure. Arch Intern Med. 1986;146:2259–61.

    Article  CAS  PubMed  Google Scholar 

  56. Lane ER, Hsu EK, Murray KF. Management of ascites in children. Exp Rev Gastroenterol Hepatol. 2015;9:1281–92.

    Article  CAS  Google Scholar 

  57. Mercaldi CJ, Lanes SF. Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest. 2013;143:532–8.

    Article  PubMed  Google Scholar 

  58. Millington SJ, Koenig S. Better with ultrasound: paracentesis. Chest. 2018;154:177–84.

    Article  PubMed  Google Scholar 

  59. Nazeer SR, Dewbre H, Miller AH. Ultrasound-assisted paracentesis performed by emergency physicians vs the traditional technique: a prospective, randomized study. Am J Emerg Med. 2005;23:363–7.

    Article  PubMed  Google Scholar 

  60. Sekiguchi H, Suzuki J, Daniels CE. Making paracentesis safer: a proposal for the use of bedside abdominal and vascular ultrasonography to prevent a fatal complication. Chest. 2013;143:1136–9.

    Article  PubMed  Google Scholar 

  61. Stone JC, Moak JH. Feasibility of sonographic localization of the inferior epigastric artery before ultrasound-guided paracentesis. Am J Emerg Med. 2015;33:1795–8.

    Article  PubMed  Google Scholar 

  62. Baumann BM, McCans K, Stahmer SA, et al. Volumetric bladder ultrasound performed by trained nurses increases catheterization success in pediatric patients. Am J Emerg Med. 2008;26:18–23.

    Article  PubMed  Google Scholar 

  63. Buntsma D, Stock A, Bevan C, et al. Success rate of BladderScan-assisted suprapubic aspiration. Emerg Med Australas. 2012;24:647–51.

    Article  PubMed  Google Scholar 

  64. Chen L, Hsiao AL, Moore CL, et al. Utility of bedside bladder ultrasound before urethral catheterization in young children. Pediatrics. 2005;115:108–11.

    Article  PubMed  Google Scholar 

  65. Gochman RF, Karasic RB, Heller MB. Use of portable ultrasound to assist urine collection by suprapubic aspiration. Ann Emerg Med. 1991;20:631–5.

    Article  CAS  PubMed  Google Scholar 

  66. Kiernan SC, Pinckert TL, Keszler M. Ultrasound guidance of suprapubic bladder aspiration in neonates. J Pediatr. 1993;123:789–91.

    Article  CAS  PubMed  Google Scholar 

  67. Milling TJ Jr, Van Amerongen R, Melville L, et al. Use of ultrasonography to identify infants for whom urinary catheterization will be unsuccessful because of insufficient urine volume: validation of the urinary bladder index. Ann Emerg Med. 2005;45:510–3.

    Article  PubMed  Google Scholar 

  68. Marin JR, Shaikh N, Docimo SG, Hickey RW, Hoberman A. Lectures for you. Suprapubic bladder aspiration [Video]. YouTube. 2015, https://www.youtube.com/watch?v=QRHOYcVCl-E.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jesse Wenger .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wenger, J., Chong, G. (2023). Ultrasound-Guided Procedures Beyond Vascular Access. In: Singh, Y., Tissot, C., Fraga, M.V., Conlon, T. (eds) Point-of-Care Ultrasound for the Neonatal and Pediatric Intensivist. Springer, Cham. https://doi.org/10.1007/978-3-031-26538-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-26538-9_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-26537-2

  • Online ISBN: 978-3-031-26538-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics