The changes and role of intracavitary electrocardiogram in the placement of peripherally inserted central venous catheters / 中华护理杂志

ABSTRACT

Objective To analyze the changes of P wave of intracavitary electrocardiogram (ECC) in the placement of periph erally inserted central venous catheters (PICC), and to explore whether the intracavitary ECG can be used to guide the procedure. Methods PICC was inserted in 62 adult patients under intracavitary ECC-guided technique. The intracavitary ECC were recorded in different parts of vessel access through micro-guidewire. Results The intracavitary ECG extracted through micro-guidewire were accurately recorded in all patients. The amplitudes of P wave were (1.11 ±0.36)mm, (1.12±0.28)mm,(1.56±0.45)mm, (4.03±1.87)mm, (5.90±2.45)mm, (7.90±2.95)mm, (9.87±2.77)mm, (5.00±1.76)mm, (2.50±1.73)mm when PICC tip was located in the axillary, subclavian and brachiocephalic vein, in the superior, middle and inferior SVC, at the SVC-right atrium junction, and in the middle, inferior right atrium,respectively. The amplitude of P wave was 1.14±0.34mm in 10 patients with PICC tip malposition in the internal jugular vein. Conclusions The intracavitary ECG can be extracted with the microguidewire of PICC system. The amplitude of P wave is related to the location of PICC tip, which can be used to guide the PICC insertion and positioning.