title: An alternative technique for accurate placement of central venous catheter tips.
abstract: For intravenous electrocardiography (IVECG), a wire stylet is usually utilized as the exploring probe to correctly position the central venous catheter. We present an alternative technique using the transduction probe connected to the original right arm lead of the ECG monitor to accurately position the central venous catheter. We compared the efficacy and quality of the IVECG signals of the two techniques. Sixty patients were randomly enrolled into two groups. In group G, the IVECG signal was conducted from the guide wire to identify the correct catheter tip position. In group T, the IVECG signal was conducted from the transduction probe to ascertain the tip position. The quality of IVECG signals, which included baseline drift, P-wave pattern, and QRS wave pattern, were assessed for 10 seconds. There was no obvious difference between the groups for catheter tip placement time or measured optimal catheter length. During manipulation, the incidence of cardiac dysrhythmia was higher in group G than in group T, but the difference was not significantly different (p = 0.09). Satisfactory IVECG signal quality was observed in 26 of the 30 patients in group G and in 27 of the 30 patients in group T. We conclude that the transduction probe can effectively conduct IVECG signals with no specific additional equipment required. It is an alternative technique for accurate placement of central venous catheter tips during IVECG.
authors.affiliation: Department of Anesthesiology, Kuo General Hospital, Tainan, ROC.
authors.forename: Koung-Shing
authors.initials: KS
authors.lastname: Chu
authors.forename: Chao-Shun
authors.initials: CS
authors.lastname: Tang
authors.forename: Shen-Long
authors.initials: SL
authors.lastname: Howng
authors.forename: Kwong-Leung
authors.initials: KL
authors.lastname: Yu
authors.forename: Hong-Te
authors.initials: HT
authors.lastname: Hsu
authors.forename: Kuang-I
authors.initials: KI
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged