title: CVP catheter electrocardiography: an alternative to radiographic control after cannulation of central veins?
abstract: We evaluated 160 electrocardiograms taken after placement of central venous catheters (CVC) to determine their locations. Usable recordings were obtained in 154 patients. Subsequent radiographs revealed 30 misplaced catheters. Twenty-five of those were detected by CVC electrocardiograms. There were five false positive and five false negative traces. The sensitivity of CVC electrocardiography was 96%, the specificity 83.3%, and the total predictive power 93.5%. Electrocardiograms obtained from guide-wires were of significantly better quality than those from 0.9% NaCl filled catheters. The technique is accurate, safe and easy to learn. It may reduce the need for routine radiographic control to less than 10% of patients.
authors.affiliation: Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Koscielniak-Nielsen
authors.forename: S
authors.initials: S
authors.lastname: Otkjaer
authors.forename: O B
authors.initials: OB
authors.lastname: Hansen
authors.forename: C
authors.initials: C
authors.lastname: Hemmingsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D007601:Jugular Veins; D008875:Middle Aged; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D013350:Subclavian Vein; D014683:Vena Cava, Superior