Accurate placement of central venous catheters in pediatric patients using endocavitary electrocardiography: Reassessment of a personal technique

Gian Battista Parigi, Giovanni Verga

Research output: Contribution to journalArticle

Abstract

To avoid the need for radiological control in the assessment of the proper location of central venous catheters (CVC), a particular use of endocavitary electrocardiography (EC-ECG) was proposed 10 years ago. The aim of this study is to reassess our experience with this method. EC-ECG assumes that the CVC, when filled with normosaline and connected to a standard electrocardiograph, behaves like an exploring electrode. The approach of the catheter tip to the right atrium is then detected by a slightly increasing negative P wave. When the tip reaches the exact level of the sinus node, the P wave suddenly deepens. After a preliminary test of the reliability of the technique versus the standard method in 50 CVC placements verified by both EC-ECG and chest x-ray, we have placed 807 CVCs in children using EC-ECG only. There have been no false-positive and one false-negative test result (lead connector misplacement). In 17 cases in which intrinsic deflection was not detected, the catheter tip was found to be wrongly positioned; all the remainder CVCs have been successfully positioned. For 10 years this technique has proved to be a simple, safe, quick, inexpensive and highly reliable method to assess the correct petitioning of the CVC.

Original languageEnglish
Pages (from-to)1226-1228
Number of pages3
JournalJournal of Pediatric Surgery
Volume32
Issue number8
DOIs
Publication statusPublished - Aug 1997

Keywords

  • Central venous catheter placement
  • Central venous catheters
  • Chemotherapy
  • Endocavitary electrocardiography
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Surgery

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