Key result
Intracavitary electrocardiography for tip location of ultrasound-guided central catheters in neonates demonstrated 100% applicability, feasibility, and accuracy with no adverse events.
Why the study?
Traditional central venous catheter tip location is considered inaccurate and not cost-effective, prompting guideline recommendations to adopt intracavitary electrocardiography whenever possible.
Does intracavitary electrocardiography (IC-ECG) accurately and safely locate the tip of centrally inserted central venous catheters in neonates?
Observational (n=105)
Does intracavitary electrocardiography (IC-ECG) accurately and safely locate the tip of centrally inserted central venous catheters in neonates?
Answers are grounded in this paper and cite their sources.
IC-ECG is a safe, feasible, and 100% accurate method for locating the tip of centrally inserted central venous catheters in neonates.
BACKGROUND: The correct position of the tip of a central venous access device is important in all patients, and especially in neonates. The traditional method of tip location (approximated intra-procedural length estimation + post procedural chest X-ray) is currently considered inaccurate and not cost-effective by most recent guidelines, which recommend the adoption of tip location by intracavitary electrocardiography (IC-ECG) whenever possible. METHODS: This study prospectively investigated the applicability, the feasibility, the accuracy, and the safety IC-ECG for tip location in neonates requiring insertion of ultrasound-guided centrally inserted central venous catheters (CICCs) with caliber 3Fr or more. All catheter tip locations were verified using simultaneously both IC-ECG and ultrasound-based tip location, using the Neo-ECHOTIP protocol. RESULTS: A total of 105 neonates were enrolled. The applicability of IC-ECG was 100% since a P wave was evident on the surface ECG of all neonates recruited for the study. The feasibility was also 100% since an increase of the P-wave was detected in all cases. The accuracy was also 100%, since a perfect match between IC-ECG based tip location and ultrasound-based tip location was found. There were no adverse events directly or indirectly related to the IC-ECG technique; no arrhythmias occurred. CONCLUSIONS: When applied to ultrasound guided CICCs, tip location by IC-ECG is applicable and feasible in neonates, and it is safe and accurate.
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D’Andrea et al. (2022) conducted an observational in Neonates requiring centrally inserted central venous catheters (n=105). Intracavitary electrocardiography (IC-ECG) vs. Ultrasound-based tip location was evaluated on Applicability, feasibility, and accuracy. Intracavitary electrocardiography for tip location of ultrasound-guided central catheters in neonates demonstrated 100% applicability, feasibility, and accuracy with no adverse events.
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