A new wireless device for bedside assessment of tip location of central venous access devices using intracavitary ECG: A retrospective study

Abstract

Intracavitary electrocardiography (IC-ECG) is a non-invasive method for intraprocedural tip location during central venous catheterization. Over the last 20 years, the IC-ECG method has been thoroughly investigated and many studies have confirmed its wide applicability and feasibility, as well as its great accuracy and safety in different populations of patients and in different types of central venous access devices (CVADs). This retrospective study presents a two-center experience with tip location of central venous catheters using IC-ECG, by means of a new wireless portable device. Tip location was performed during 983 insertions of CVADs at bedside, using this new device. Clinical conditions with limited or no applicability of IC-ECG were excluded. The feasibility of IC-ECG, as performed using the novel device, was 92.2%. This wireless device may play an important role in central venous catheterization at bedside, since it is pocket-sized, particularly easy to use, and easy to sanify after use.

Keywords

Tip location intracavitary ECG PICC central venous catheterization wireless device wireless ultrasound

Get full access to this article

View all access options for this article.

References

Pittiruti

Hamilton

Biffi

, et al. ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr 2009; 28(4): 365–377.

Pittiruti

Pelagatti

Pinelli

Intracavitary electrocardiography for tip location during central venous catheterization: a narrative review of 70 years of clinical studies. J Vasc Access 2021; 22(5): 778–785.

Nickel

Gorski

Kleidon

, et al. Infusion therapy standards of practice, 9th edition. J Infus Nurs 2024; 47(1S): S1–S285.

Kleidon

Horowitz

Rickard

, et al. Peripherally inserted central catheter thrombosis after placement via electrocardiography vs traditional methods. Am J Med 2021; 134(2): e79–e88.

Liu

Zheng

Zhen

, et al. Efficacy, safety, and cost-effectiveness of intracavitary electrocardiography-guided catheter tip placement for totally implantable venous access port. Ann Vasc Surg 2022; 83: 168–175.

Chu

Hsu

Wang

, et al. Accurate central venous port-A catheter placement: intravenous electrocardiography and surface landmark techniques compared by using transesophageal echocardiography. Anesth Analg 2004; 98(4): 910–914.

Jeon

Ryu

Yoon

, et al. Transesophageal echocardiographic evaluation of ECG-guided central venous catheter placement. Can J Anaesth 2006; 53(10): 978–983.

Ender

Erdoes

Krohmer

, et al. Transesophageal echocardiography for verification of the position of the electrocardiographically-placed central venous catheter. J Cardiothorac Vasc Anesth 2009; 23(4): 457–461.

Iacobone

Elisei

Gattari

, et al. Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia. J Vasc Access 2020; 21: 861–867.

10.

Brescia

Pittiruti

Ostroff

, et al. The SIC protocol: a seven-step strategy to minimize complications potentially related to the insertion of centrally inserted central catheters. J Vasc Access 2023; 24(2): 185–190.

11.

Brescia

Pittiruti

Spencer

, et al. The SIP protocol update: eight strategies, incorporating Rapid Peripheral Vein Assessment (RaPeVA), to minimize complications associated with peripherally inserted central catheter insertion. J Vasc Access 2024; 25: 5–13.

12.

Calabrese

Montini

Arlotta

, et al. A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients. J Vasc Access 2019; 20(5): 516–523.

13.

Steinhagen

Kanthak

Kukuk

, et al. Electrocardiography-controlled central venous catheter tip positioning in patients with atrial fibrillation. J Vasc Access 2018; 19(6): 528–534.

14.

Zhao

Zhu

Yin

, et al. ECG method for positioning the tip of peripherally inserted central catheters in patients with atrial fibrillation. Ann Noninvasive Electrocardiol 2022; 27(3): e12931.

15.

Gao

Liu

Zhang

, et al. The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation. Ther Clin Risk Manag 2018; 14: 1075–1081.