Key result
Intracavitary electrocardiography for tip location of central venous access devices in infants <5 kg successfully detected P wave increases in 100% (27/27) of cases with only one false positive.
Why the study?
Does intracavitary electrocardiography accurately locate the tip of central venous access devices compared to echocardiography in infants weighing less than 5 kg?
Observational (n=27)
No
Does intracavitary electrocardiography accurately locate the tip of central venous access devices compared to echocardiography in infants weighing less than 5 kg?
Intracavitary electrocardiography is a safe and accurate method for locating the tip of central venous access devices in small infants, offering a viable alternative to echocardiography and potentially reducing X-ray exposure.
IC-ECG was feasible with high accuracy versus echocardiography in neonates <5 kg; supports further study but should not yet change practice.
PURPOSE:: This is a prospective observational study conducted by neonatologists in neonatal intensive care unit from Sant'Anna and San Sebastiano Hospital, Caserta, Italy. The objective of the study is to verify the feasibility of intracavitary electrocardiography method for tip location of central venous access device in infants of less than 5 kg and evaluate the accuracy of the method in comparison with post-procedural echocardiographical verification of the tip position. PATIENTS AND METHODS:: We enrolled 27 patients weighted between 0.660 and 5 kg, requiring central vascular access. Ultrasound-guided jugular internal vein access was used and after cannulation, we applied the intracavitary electrocardiography for tip location as well as post-procedural echocardiography. RESULTS:: No significant complication related to intracavitary electrocardiography occurred in the studied infants. The increase in P wave on intracavitary electrocardiography was detected in all cases (27/27). In only one case (false positive), the catheter had the tip out of cavoatrial junction-target zone (to post-procedural echocardiography). CONCLUSION:: The intracavitary electrocardiography method for tip location of central venous access device is safe and accurate in infants, as demonstrated by post-procedural comparative echocardiographic controls. As an alternative to echocardiography, not always achievable, the diffusion of intracavitary electrocardiography method could reduce X-ray exposition and complications of a malpositioned tip.
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Mastroianni et al. (2018) conducted an observational in Infants requiring central vascular access (n=27). Intracavitary electrocardiography vs. Post-procedural echocardiography was evaluated on Feasibility and accuracy of intracavitary electrocardiography for tip location. Intracavitary electrocardiography for tip location of central venous access devices in infants <5 kg successfully detected P wave increases in 100% (27/27) of cases with only one false positive.
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