{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:44:45Z","timestamp":1792680285721,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Central venous catheter malposition and pneumothorax remain clinically important complications after insertion. Many emergency departments still rely on post-procedural chest radiography, which may delay catheter use. We evaluated the diagnostic accuracy and workflow impact of point-of-care ultrasound for confirming central venous catheter position and detecting complications in the emergency department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and diagnostic test accuracy meta-analysis (International Prospective Register of Systematic Reviews (PROSPERO): CRD420251065638) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy Studies (PRISMA-DTA) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The PubMed, Embase, Cochrane Library, Web of Science Core Collection, and Scopus databases were searched from inception to 1 December 2025. Studies were considered eligible for inclusion if they enrolled adults undergoing internal jugular or subclavian central venous catheter insertion in emergency department settings and compared bedside point-of-care ultrasound (cardiac\/contrast-enhanced \u201cswirl\/bubble\u201d techniques and\/or lung ultrasound) with chest radiography and\/or computed tomography. For catheter malposition, pooled sensitivity and specificity were estimated using a bivariate random-effects model; pneumothorax accuracy and time outcomes were summarized descriptively due to sparse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of eight prospective studies (801 central venous catheter insertions) were included. Seven studies contributed estimable 2\u2009\u00d7\u20092 data for malposition. Point-of-care ultrasound showed pooled sensitivity of 0.81 (95% confidence interval: 0.50\u20130.95) and specificity of 0.99 (95% confidence interval: 0.96\u20131.00), with hierarchical summary receiver operating characteristic\u2013area under the curve of 0.99 (95% confidence interval: 0.97\u20130.99), positive likelihood ratio of 137.83 (95% confidence interval: 22.04\u2013862.02), negative likelihood ratio of 0.19 (95% confidence interval: 0.06\u20130.62), and diagnostic odds ratio of 737.34. Heterogeneity was substantial (I\n                      <jats:sup>2<\/jats:sup>\n                      : sensitivity\u2009=\u200973.85% and specificity\u2009=\u200983.37%). Pneumothorax specificity was consistently high (97.2%\u2013100%), while sensitivity varied and was often nonestimable in zero-event studies. Pneumothorax severity was rarely reported in the primary studies. Reported time savings versus chest radiography ranged from \u223c5\u2013284\u2009min (commonly \u223c20\u201360\u2009min). Deeks\u2019 test suggested no significant publication bias (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.86), although power was limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In emergency department settings, point-of-care ultrasound provides highly specific and rapid confirmation for detecting central venous catheter malposition, supporting prompt rule-in decisions and potential workflow acceleration. Given heterogeneous sensitivity and limitations of reference standards, negative results should be interpreted cautiously, with confirmatory imaging reserved for equivocal examinations or high-risk scenarios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261438344","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:18:49Z","timestamp":1776046729000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Point-of-care ultrasound for central venous catheter confirmation and complications in the emergency department: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0001-0610","authenticated-orcid":false,"given":"Xianhua","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaling","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Emergency and Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangtian","family":"Ye","sequence":"additional","affiliation":[{"name":"Hangzhou Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiuzhou","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Emergency and Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Emergency and Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency and Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5993-0737","authenticated-orcid":false,"given":"Weiting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency and Intensive Care Unit, The First People\u2019s Hospital of Linhai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Linhai Hospital of Traditional Chinese Medicine, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_3_10_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13101168"},{"key":"e_1_3_10_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.8232"},{"key":"e_1_3_10_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0803600106"},{"key":"e_1_3_10_5_2","first-page":"40","article-title":"Pneumothorax as a complication of central venous catheter insertion","volume":"3","author":"Tsotsolis N","year":"2015","unstructured":"Tsotsolis N, Tsirgogianni K, Kioumis I, et\u00a0al. 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