| Autor: |
L, Simon, A, Teboul, N, Gwinner, G, Boulay, S, Cerceau-Delaporte, J, Hamza |
| Rok vydání: |
1999 |
| Předmět: |
|
| Zdroj: |
Paediatric anaesthesia. 9(6) |
| ISSN: |
1155-5645 |
| Popis: |
Misplacement of a central venous catheter may lead to myocardial perforation and dysrhythmia. Atrial electrocardiography (ECG) through a saline column is an effective but complex method to determine the accurate location of catheters. We evaluated a simplified variant of this technique using the guidewire as an internal electrode in 23 children (5-16 years old) undergoing spinal surgery. Catheters were placed using a Seldinger technique after jugular or subclavian venous puncture. Each time the operator recognized the atrial signal, the catheter was found to be correctly placed on the chest radiograph (20/23). In three patients, the atrial signal was not obtained. A technical error was responsible in one case whereas the two others were related to aberrant migrations of the catheter either into a subclavian vein or into the pleura. In this latter case, the complication was unrecognized on the first radiograph despite malposition having been predicted by atrial ECG. We conclude that a method using atrial ECG guidance is sensitive and specific, and may be an alternative to the classical chest radiograph to detect accurate placement of central venous catheters in children. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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