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

Fingerprint

Central Venous Catheters
Electrocardiography
Pediatrics
Catheters
Sinoatrial Node
Heart Atria
Electrodes
Thorax
X-Rays

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

@article{da1f0502862449f1bbad870c9611b838,
title = "Accurate placement of central venous catheters in pediatric patients using endocavitary electrocardiography: Reassessment of a personal technique",
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.",
keywords = "Central venous catheter placement, Central venous catheters, Chemotherapy, Endocavitary electrocardiography, Total parenteral nutrition",
author = "Parigi, {Gian Battista} and Giovanni Verga",
year = "1997",
month = "8",
doi = "10.1016/S0022-3468(97)90687-4",
language = "English",
volume = "32",
pages = "1226--1228",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Accurate placement of central venous catheters in pediatric patients using endocavitary electrocardiography

T2 - Reassessment of a personal technique

AU - Parigi, Gian Battista

AU - Verga, Giovanni

PY - 1997/8

Y1 - 1997/8

N2 - 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.

AB - 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.

KW - Central venous catheter placement

KW - Central venous catheters

KW - Chemotherapy

KW - Endocavitary electrocardiography

KW - Total parenteral nutrition

UR - http://www.scopus.com/inward/record.url?scp=0030695984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030695984&partnerID=8YFLogxK

U2 - 10.1016/S0022-3468(97)90687-4

DO - 10.1016/S0022-3468(97)90687-4

M3 - Article

C2 - 9269975

AN - SCOPUS:0030695984

VL - 32

SP - 1226

EP - 1228

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 8

ER -