Incidence of arrhythmia with central venous catheter insertion and exchange
| Autor: | Charlott Champagne, Scott A. Shikora, Ann Jennings, Pau Akerman, Jeffrey A. Lowell, Regina K. Stuart, Mary Keane-Ellison, Caroli Apovian, John K. Baxter, Bruce R. Bistrian |
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| Rok vydání: | 1990 |
| Předmět: |
Catheterization
Central Venous Parenteral Nutrition Resuscitation medicine.medical_treatment Medicine (miscellaneous) Electrocardiography medicine Humans cardiovascular diseases Monitoring Physiologic Nutrition and Dietetics medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Cardiac arrhythmia Arrhythmias Cardiac Body Height Catheter Anesthesia cardiovascular system Equipment Failure Cardiac monitoring business Complication Central venous catheter |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 14:152-155 |
| ISSN: | 1941-2444 0148-6071 |
| DOI: | 10.1177/0148607190014002152 |
| Popis: | The risk of complication during the insertion or exchange of central venous catheters has been well documented. The majority of complications involve mechanical problems associated with insertion. Although cardiac arrhythmia has been acknowledged as a possible complication, its incidence has never been quantified. We performed cardiac monitoring on patients during 51 central venous catheter insertions or exchanges to determine the incidence of cardiac arrhythmias during guidewire insertion. Forty-one percent of procedures resulted in atrial arrhythmias and 25% produced some degree of ventricular ectopy, 30% of these were ventricular couplets or greater. Ventricular ectopy was significantly more common in shorter patients (160 +/- 8 vs 168 +/- 11 cm, p less than 0.05) and when the catheter was inserted from the right subclavian position (43% ventricular ectopy vs 10% at the other sites). Other variables such as age, cardiac history, serum potassium, type of procedure, and catheter brand were not significant. It is our conclusion that over-insertion of the wire causes this cardiac stimulation. Despite the absence of morbidity or mortality in this study, this incidence of ventricular ectopy indicates that there is a distinct possibility of a malignant arrhythmia being precipitated by a guidewire. Some modification of the current protocol for these procedures seems indicated. |
| Databáze: | OpenAIRE |
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