USE OF INTRAVENOUS ELECTROCARDIOGRAM IN PLACEMENT OF THE TIP OF PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN OPTIMUM POSITION

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JALAEIAN TAGHADOMI R.; MOTAHEDI B.; GHANAD M.A.; PEYVANDI A.

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Journal: Iranian Journal of Surgery Year:2005 | Volume:13 | Issue:2 (35) Page(s): 36-42

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Title

USE OF INTRAVENOUS ELECTROCARDIOGRAM IN PLACEMENT OF THE TIP OF PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN OPTIMUM POSITION

Author(s)

JALAEIAN TAGHADOMI R. | MOTAHEDI B. | GHANAD M.A. | PEYVANDI A. | Issue Writer Certificate

Keywords

CENTRAL VENOUS PRESSURE (CVP)Q4

INTRAVENOUS ELECTROCARDIOGRAM (IVECG)Q4

CORONARY ARTERY BYPASS GRAFT (CABG)Q4

Abstract

Introduction & Objective: Insertion of the CVP catheters through internal jugular and subclavian veins has a high incidence of major complications like pneumothorax, arterial puncture and nerve injury. Sometimes we use peripherally inserted central catheters (PICC) which have very few major complications. As, correct placement of the tip of these catheters is difficult, intravascular ECG, is used to determine the position of the tips of these catheters.Materials & Methods: In 105 patients undergoing CABG, 16 gauge, 70 cm length catheters (cavafix) were inserted through basilic and median basilic veins. The patients were randomly divided into two groups of right and left hands. Before the insertion a guide wire (used in urologic endoscopic surgery) was inserted into the catheters, so that the tip of the wire would extend just to the tip of the catheter. The proximal end of the guide wire was attached to a chest lead, and the negative electrode of the lead II (right arm) was joined to this chest lead. While advancing the catheter toward the right atrium, the P wave height of the lead 11was recorded from the wire on the monitoring screen. The tallest P ware was recorded when the tip of the guide wire was close to SA node, which is located at the junction of SVC and RA. The guide wire was removed at this point and the catheter was fixed. The correct position of the catheter tip was confirmed by the surgeon during operation.Results: In 76 patients (72.4%), the tip of the catheter was located exactly at the junction of SVC and RA. In 14 patients (13.3%), it was within 1 cm of the junction. In six patients (5.7%), the tip of the catheter was not palpated by the surgeon although P wave changes were observed. In 9 patients(8.6%)no P wave changes were detected, and the tip of the catheter was not palpated by the surgeon. In this group, the catheters had been misplaced into the internal jugular veins, that was confirmed after the operation by chest x-ray. In 8 patients of this group, the catheter had been inserted through the right hand.Conclusions: Placement of PICC is a safe method. We can place the catheters tip in an optimum position by the use of IVECG. Performing this procedure is very easy and does not need much experience. If the catheter is misplaced during insertion, we will be able to detect this problem and we can insert it through other veins.

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APA: Copy

JALAEIAN TAGHADOMI, R., MOTAHEDI, B., GHANAD, M.A., & PEYVANDI, A.. (2005). USE OF INTRAVENOUS ELECTROCARDIOGRAM IN PLACEMENT OF THE TIP OF PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN OPTIMUM POSITION. IRANIAN JOURNAL OF SURGERY, 13(2 (35)), 36-42. SID. https://sid.ir/paper/112890/en

Vancouver: Copy

JALAEIAN TAGHADOMI R., MOTAHEDI B., GHANAD M.A., PEYVANDI A.. USE OF INTRAVENOUS ELECTROCARDIOGRAM IN PLACEMENT OF THE TIP OF PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN OPTIMUM POSITION. IRANIAN JOURNAL OF SURGERY[Internet]. 2005;13(2 (35)):36-42. Available from: https://sid.ir/paper/112890/en

IEEE: Copy

R. JALAEIAN TAGHADOMI, B. MOTAHEDI, M.A. GHANAD, and A. PEYVANDI, “USE OF INTRAVENOUS ELECTROCARDIOGRAM IN PLACEMENT OF THE TIP OF PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN OPTIMUM POSITION,” IRANIAN JOURNAL OF SURGERY, vol. 13, no. 2 (35), pp. 36–42, 2005, [Online]. Available: https://sid.ir/paper/112890/en

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