CVP catheter electrocardiography: an alternative to radiographic control after cannulation of central veins?
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.
Koscielniak-Nielsen
Z J
ZJ
Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Otkjaer
S
S
Hansen
O B
OB
Hemmingsen
C
C
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