The accuracy of electrocardiogram-controlled central line placement
| Autor: | Vladimir Melnikov, Peter Szmuk, Evan G. Pivalizza, Christianne Vogt, Robert D. Warters, Ralf E. Gebhard |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Catheterization Central Venous MEDLINE Body weight Preoperative care law.invention Electrocardiography Randomized controlled trial law Preoperative Care medicine Humans cardiovascular diseases Monitoring Physiologic medicine.diagnostic_test business.industry Patient Selection Body Weight Middle Aged Central line placement Surgery Anesthesiology and Pain Medicine Elective Surgical Procedures Female Safety business Elective Surgical Procedure Software |
| Zdroj: | Anesthesia and analgesia. 104(1) |
| ISSN: | 1526-7598 |
| Popis: | Electrocardiogram (ECG) guidance to confirm accurate positioning of central venous catheters (CVC), placed before surgery in the operating room, is rarely used in the United States. We designed this randomized, controlled trial to investigate whether the use of this technique impacts the accuracy of CVC placement.Patients in group ECG (n = 147) had a CVC placed using right-atrial ECG to guide catheter tip positioning. CVCs in group NO-ECG (n = 143) were positioned without this technique.Overall, guidewire-ECG control resulted in more correctly positioned CVCs (96% vs 76%, Por = 0.001) without increasing placement time. Significantly more CVCs were placed in the middle of the superior vena cava in group ECG (Por = 0.001), although placement into the right atrium or right ventricle and into other vessels occurred significantly more often in group NO-ECG (Por = 0.001). Twenty patients in group NO-ECG required repositioning of their CVC after surgery, whereas this maneuver was necessary only in three patients in group ECG (Por = 0.001).ECG guidance allows for more accurate CVC placement, and should be considered to increase patient safety and reduce costs associated with repositioning procedures. |
| Databáze: | OpenAIRE |
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