Clinical Research of Electrocardiogram Monitoring Assisted Ultrasound Guidance for Modified Seldinger Technique in Peripherally Inserted Central Catheters / 中国循环杂志

ABSTRACT

Objective: To study electrocardiogram (ECG) monitoring assisted ultrasound guidance for modiifed seldinger technique (MST) in peripherally inserted central catheters (PICC) and to estimate the accuracy of ECG for presenting catheter tip location. Methods: The patients were connected with ECG monitoring system, the guide wire was connected to RA electrode in ECG monitor for leading out P wave of intracavitary ECG. The location of catheter tip was estimated by P wave characteristics and then, estimated ECG result was further compared with chest X-ray presented catheter tip position. The coherence of catheter tip position between ECG and chest X-ray was compared, the sensitivity and speciifcity of ECG estimation were calculated. Results: There were 100/104 patients showed speciifc P wave in ECG, the coherence to chest X-ray was 96.2%; 4 patients had no speciifc P wave and their chest X-ray presented that the catheter tip position at upper superior vena cava in 2 patients, at lower superior vena cava in 1 patient, at contralateral brachiocephalic vein in 1 patient. The accuracy of 2 methods had no statistic meaning. ECG estimation for PICC catheter tip position had the sensitivity at 99% and speciifcity at 100%. Conclusion: ECG monitoring may determine the catheter tip position for MST in PICC guided by ultrasound. It doesn’t need chest X-ray, without additional trauma and no radioactive contamination, which make PICC catheters get more extensive application in clinical practice.