Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement
Background: The current standard followed for assessing central venous catheter (CVC) tip placement location is through radiological confirmation using chest X-ray (CXR). Placement of CVCs under electrocardiogram (ECG) guidance may save cost and time compared to CXR. Objective: The objective of this...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Emergencies, Trauma and Shock |
| Subjects: | |
| Online Access: | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=4;spage=276;epage=281;aulast=Krishnan |
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| author | Arun Kumar Krishnan Priya Menon K P Gireesh Kumar T P Sreekrishnan Manish Garg S Vijay Kumar |
| author_facet | Arun Kumar Krishnan Priya Menon K P Gireesh Kumar T P Sreekrishnan Manish Garg S Vijay Kumar |
| author_sort | Arun Kumar Krishnan |
| collection | DOAJ |
| description | Background: The current standard followed for assessing central venous catheter (CVC) tip placement location is through radiological confirmation using chest X-ray (CXR). Placement of CVCs under electrocardiogram (ECG) guidance may save cost and time compared to CXR. Objective: The objective of this study is to compare the accurate placement of the CVC tip using anatomical landmark technique with ECG-guided technique. Another objective is to compare CVC placement time and postprocedural complications between the two techniques. Methods and Materials: A total of 144 adult individuals, who were critically ill and required CVC placement in the Emergency Department, were included for the study. Study duration was 6 months. Anatomical landmark and ECG-guided groups were assigned 72 participants each. Analyses were performed using t and Chi square-tests. Results: It was observed that 13 (18%) in the landmark technique were malpositioned as compared to none in the ECG-guided technique (P = 0.000). The landmark group had 22 (30.6%) participants with arrhythmias during the procedure, compared to none in the ECG-guided group (P = 0.000). The landmark group revealed that 30 (41.7%) of the CVC were overinserted and required immediate repositioning, compared to none in the ECG-guided group (P = 0.000). Conclusion: ECG-guided technique was found to be more accurate for CVC tip placement than the anatomical landmark technique. Furthermore, the ECG-guided technique was more time-effective and had less complications than the anatomical landmark technique. Hence, ECG-guided CVC placement is relatively accurate, efficient, and safe and can be considered as an alternative method to conventional radiography for confirmation of CVC tip placement. |
| first_indexed | 2024-12-17T13:27:23Z |
| format | Article |
| id | doaj.art-e937ba17b742449a8088241a218e6287 |
| institution | Directory Open Access Journal |
| issn | 0974-2700 |
| language | English |
| last_indexed | 2024-12-17T13:27:23Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Emergencies, Trauma and Shock |
| spelling | doaj.art-e937ba17b742449a8088241a218e62872022-12-21T21:46:41ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002018-01-0111427628110.4103/JETS.JETS_122_17Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placementArun Kumar KrishnanPriya MenonK P Gireesh KumarT P SreekrishnanManish GargS Vijay KumarBackground: The current standard followed for assessing central venous catheter (CVC) tip placement location is through radiological confirmation using chest X-ray (CXR). Placement of CVCs under electrocardiogram (ECG) guidance may save cost and time compared to CXR. Objective: The objective of this study is to compare the accurate placement of the CVC tip using anatomical landmark technique with ECG-guided technique. Another objective is to compare CVC placement time and postprocedural complications between the two techniques. Methods and Materials: A total of 144 adult individuals, who were critically ill and required CVC placement in the Emergency Department, were included for the study. Study duration was 6 months. Anatomical landmark and ECG-guided groups were assigned 72 participants each. Analyses were performed using t and Chi square-tests. Results: It was observed that 13 (18%) in the landmark technique were malpositioned as compared to none in the ECG-guided technique (P = 0.000). The landmark group had 22 (30.6%) participants with arrhythmias during the procedure, compared to none in the ECG-guided group (P = 0.000). The landmark group revealed that 30 (41.7%) of the CVC were overinserted and required immediate repositioning, compared to none in the ECG-guided group (P = 0.000). Conclusion: ECG-guided technique was found to be more accurate for CVC tip placement than the anatomical landmark technique. Furthermore, the ECG-guided technique was more time-effective and had less complications than the anatomical landmark technique. Hence, ECG-guided CVC placement is relatively accurate, efficient, and safe and can be considered as an alternative method to conventional radiography for confirmation of CVC tip placement.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=4;spage=276;epage=281;aulast=KrishnanAnatomical landmarkscatheter tipcentral venous catheterelectrocardiogram-guided |
| spellingShingle | Arun Kumar Krishnan Priya Menon K P Gireesh Kumar T P Sreekrishnan Manish Garg S Vijay Kumar Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement Journal of Emergencies, Trauma and Shock Anatomical landmarks catheter tip central venous catheter electrocardiogram-guided |
| title | Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement |
| title_full | Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement |
| title_fullStr | Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement |
| title_full_unstemmed | Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement |
| title_short | Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement |
| title_sort | electrocardiogram guided technique an alternative method for confirming central venous catheter tip placement |
| topic | Anatomical landmarks catheter tip central venous catheter electrocardiogram-guided |
| url | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=4;spage=276;epage=281;aulast=Krishnan |
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