Recording of Intracavity Potentials Through a Single Lumen, Saline Filled Cardiac Catheter

Hellerstein, Herman K.; Pritchard, Walter H.; Lewis, Robyn

doi:10.3181/00379727-71-17078

Cited by 51 publications

(32 citation statements)

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“…Although ECG guidance for CVC positioning was suggested as early as 1949 (10), this method is not widely used in the United States. This could be explained, at least in part, by the lack of conclusive evidence.…”

Section: Discussionmentioning

confidence: 97%

The Accuracy of Electrocardiogram-Controlled Central Line Placement

Gebhard¹,

Szmuk²,

Pivalizza³

et al. 2007

Anesthesia & Analgesia

106

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Section: Discussionmentioning

confidence: 97%

The Accuracy of Electrocardiogram-Controlled Central Line Placement

Gebhard¹,

Szmuk²,

Pivalizza³

et al. 2007

Anesthesia & Analgesia

106

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“…Of them, the most frequently used techniques are traditional anatomical landmark guidance, followed by IC ECG guidance [5, 27]. The latter technique, which uses ECG to guide CVC placement, emerged in 1949 [28], and a number of non-randomized studies have recently been published regarding its performance and safety. These studies all agree that ECG technique performs well for the positioning of PICCs [1, 13].…”

Section: Discussionmentioning

confidence: 99%

Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: A randomized open-label controlled multicenter study

Yuan

Meng

et al. 2017

PLoS ONE

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BackgroundIntracavitary electrocardiogram (IC ECG) guidance emerges as a new technique for peripherally inserted central catheters (PICCs) placement and demonstrates many potential advantages in recent observational studies.AimsTo determine whether IC ECG-guided PICCs provide more accurate positioning of catheter tips compared to conventional anatomical landmarks in patients with cancer undergoing chemotherapy.MethodsIn this multicenter, open-label, randomized controlled study (ClinicalTrials.gov number, NCT02409589), a total of 1,007 adult patients were assigned to receive either IC ECG guidance (n = 500) or anatomical landmark guidance (n = 507) for PICC positioning. The confirmative catheter tip positioning x-ray data were centrally interpreted by independent radiologists. All reported analyses in the overall population were performed on an intention-to-treat basis. Analyses of pre-specified subgroups and a selected large subpopulation were conducted to explore consistency and accuracy.ResultsIn the IC ECG-guided group, the first-attempt success rate was 89.2% (95% confidence interval [CI], 86.5% to 91.9%), which was significantly higher than 77.4% (95% CI, 73.7% to 81.0%) in the anatomical landmark group (P < 0.0001). This trend of superiority of IC ECG guidance was consistently noted in almost all prespecified patient subgroups and two selected large subpopulations, even when using optimal target rates for measurement. In contrast, the superiority nearly disappeared when PICCs were used via the left instead of right arms (interaction P-value = 0.021). No catheter-related adverse events were reported during the PICC intra-procedures in either group.ConclusionsOur findings indicated that the IC ECG-guided method had a more favorable positioning accuracy versus traditional anatomical landmarks for PICC placement in adult patients with cancer undergoing chemotherapy. Furthermore, there were no significant safety concerns reported for catheterization using the two techniques.

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“…It is endemic in the tropical and subtropical areas of the world especially in Southeast Asia, the Pacific, East and West Africa, the Caribbean and the Americas with cyclical epidemics in these areas. [1,2] Dengue fever can manifest as mild, undifferentiated fever or a more severe form of the disease called dengue hemorrhagic fever (DHF: grades I-IV). The most critical phase of this viral infection is defervescent when the fever subsides but the patient develops life-threatening thrombocytopenia due to complement activation by viral antigens binding to the platelets.…”

Section: Dengue Fever In a Patient Recovering From Coronary Artery Bymentioning

confidence: 99%

“…Other methods described in recent times n e e d ex p e n s i v e e q u i p m e n t s u c h a s ultrasound or echocardiography. Although electrocardiogram (ECG) guidance for CVC positioning was suggested as early as 1949, [1] this method is not widely used. A recent studyby Von Hellerstein [2] has shown that the chance of correct placement of CVC using the ECG-controlled technique is 96% versus 76% with the conventional technique.…”

mentioning

confidence: 99%