{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:36:00Z","timestamp":1791606960102,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urethral catheterization is the standard method for obtaining sterile urine in nontoilet\u2010trained children, but the conventional blind technique frequently results in futile attempts (\u201cdry taps\u201d) on empty bladders. Point\u2010of\u2010care ultrasound (POCUS) offers the clinical advantage of confirming adequate urine volume to prevent mucosal trauma and procedural distress. However, its routine implementation may be limited by operator training requirements and potential workflow delays while waiting for bladder filling. Therefore, this study aims to evaluate the efficacy of real\u2010time POCUS\u2010assisted versus standard blind urethral catheterization in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis of randomized controlled trials (RCTs) adhering to PRISMA guidelines (PROSPERO: CRD420251247483). We searched PubMed, Embase, and CENTRAL for trials comparing POCUS\u2010guided versus standard catheterization in children aged \u2264\u200936\u2009months. The primary outcome was the first\u2010attempt success rate. The certainty of evidence was evaluated using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three trials comprising 337 participants were included. POCUS\u2010assisted catheterization significantly increased first\u2010attempt success compared to the conventional technique (89.7% vs. 72.5%; RR 1.25, 95% CI 1.08\u20131.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0022), yielding a Number Needed to Treat (NNT) of 6. Furthermore, ultrasound guidance significantly reduced the rate of \u201cdry taps\u201d (3.6% vs. 23.9%; RR 0.25, 95% CI 0.13\u20130.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), representing an NNT of 5 to prevent one futile attempt. The certainty of evidence for the primary outcome was rated as moderate. Secondary descriptive outcomes indicated higher caregiver satisfaction, lower perceived patient discomfort, and comparable overall workflow times despite required waiting periods for bladder filling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Real\u2010time POCUS significantly improves first\u2010attempt catheterization success and drastically reduces futile attempts in young children. Furthermore, it enhances caregiver satisfaction and minimizes patient distress without intrinsically delaying emergency department workflow. These highly actionable findings support the integration of ultrasound guidance into routine pediatric emergency care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70342","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:50:13Z","timestamp":1780660213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Point\u2010of\u2010Care Ultrasound for Pediatric Urethral Catheterization: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3161-4538","authenticated-orcid":false,"given":"Henrique Faustino","family":"Vieira da Silva","sequence":"first","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6674-9713","authenticated-orcid":false,"given":"Enzo Tatsumi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3105-7105","authenticated-orcid":false,"given":"Mariana Cosas","family":"Tavares","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0605-381X","authenticated-orcid":false,"given":"Ana Clara","family":"Ramos Bicalho","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3680-2032","authenticated-orcid":false,"given":"Luigi de Souza Dias","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-3882","authenticated-orcid":false,"given":"Ana Cristina","family":"Sim\u00f5es e Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1330"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2019.10.006"},{"key":"e_1_2_10_4_1","volume-title":"Urinary Tract Infection in Under 16s: Diagnosis and Management [NG224]","author":"National Institute for Health and Care Excellence (NICE)","year":"2022"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31815e4122"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.1181"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1332"},{"issue":"10","key":"e_1_2_10_8_1","first-page":"655","article-title":"Spontaneous Urine Collection in Febrile Infants: A Reliability Study","volume":"21","author":"McGillivray D.","year":"2005","journal-title":"Pediatric 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