[Clinical use of a new cava catheter with an ECG lead over a steel mandrin].
Placement of central venous catheters via an intra-atrial ECG lead is becoming more and more wide-spread. A new catheter model was used in 182 patients. The ECG was obtained using an intraluminal wire as the conducting material instead of an electrolyte solution. In 139 cases the catheter positions were also verified by chest X-ray (CXR). In 125 cases accurate positioning of the catheter was seen on CXR. In 13 cases the catheter was withdrawn 1-3 cm, in one case by 4 cm (this catheter was inserted via V. basilica). The reliability of catheter placement by ECG monitoring was confirmed, since distinction between the right atrium and superior vena cava is often not possible with certainty and it is often necessary to withdraw the catheter tip further into the middle of the superior vena cava. It might thus be assumed that even those catheters evaluated by CXR as being too deep were extra-atrial. The catheter that was 4 cm too deep was inserted via the V. basilica. Such catheters can migrate several centimeters on arm movement, and hence, during their placement adduction of the arm is advised. We conclude that an ECG obtained using an intraluminal wire is superior to an electrolyte solution since the splinted catheter can be pushed forward more easily, no air bubbles disturbing electrical conductance are possible, and thus clinical use is easier.
Hausser
J
J
Institut für Anaesthesiologie des Klinikums der Stadt Nürnberg.
D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000295:instrumentation*; D006801:Humans
Klinische Anwendung eines neuen Cava-Katheters mit EKG-Ableitung über Stahlmandrin.