Positioning of peripherally inserted central catheters tips using intracavitary electrocardiogram / 中华临床营养杂志

ABSTRACT

Objective To explore the value of using the characteristic P wave of the intracavitary electrocardiogram (ECG) in positioning the tips of the peripherally inserted central catheters (PICC).Methods Totally 201 patients with PICC from December 1,2015 to February 29,2016 were enrolled in this study.The characteristic P wave of the intracavitary ECG was applied to locate the PICC tips.The pre-determined depth of catheter insertion (Y),highest P wave (L),and actual insertion depth (Z) were recorded.Chest radiography was performed after a successful insertion of PICC.The optimal depth (H) was recorded.Then we observed the sensitivity of P wave in positioning PICC tips,the operative time of positioning PICC tip with intracavitary ECG,and the difference in the predicted depth and the actual depth of PICC insertion.Results The sensitivity of the intracavitary ECG in positioning PICC tips was 100％.The operation time of the intracavitary ECG in guiding PICC tip was significantly shorter than the that of ultrasonic diagnosis of ectopic PICC [(3.4 ± 2.4) min vs.(5.6 ± 3.4) min] (P =0.006 9).The actual depth of ECG-guided positioning was significantly more accurate than the predicted depth [(0.4 ± 0.1) cm vs.(3.9 ± 0.8) cm] (P =0.007 2).L minused Z averaged (4.3 ± 1.6) cm.Conclusion Positioning PICC tips with ECG is simple,accurate,and easy to learn,and it is worth to be widely used in clinical settings.