Key result
Intravenous electrocardiography use during totally implantable venous access device placement resulted in a higher rate of proper catheter tip position compared to surface landmarks (97.3% vs 88.8%, P<0.05).
Why the study?
Does intravenous electrocardiography improve proper catheter tip position in patients receiving totally implantable venous access device implantation by inexperienced operators?
Observational (n=331)
No
Does intravenous electrocardiography improve proper catheter tip position in patients receiving totally implantable venous access device implantation by inexperienced operators?
Absolute Event Rate: 97.3% vs 88.8%
p-value: p=< 0.05
Intravenous electrocardiography significantly improves the accuracy of totally implantable venous access device placement by inexperienced operators compared to surface landmarks.
May improve tip accuracy for inexperienced operators; leaves open need for randomized confirmation.
BACKGROUND: Proper tip position is a major determinant of totally implantable venous access device (TIVAD) outcome. The aim of this study is to analyze the potential utilization of intravenous electrocardiography (IV-ECG) to help inexperienced operators for TIVAD placement. PATIENTS AND METHODS: This is a retrospective, observational, uni-institutional study. 331 patients receiving TIVAD implantation from July 2008 to December 2008 were recruited. In IV-ECG group, IV-ECG was used to help decide catheter tip location and catheter length. In Landmark group, catheter length was decided by surface landmarks. Catheter tip position was confirmed by post-operative supine chest X-ray. RESULTS: There were 153 patients in IV-ECG group, and 178 patients in Landmark group. No immediate reoperation due to catheter mal-position was noted in IV-ECG group, but it happened in eight patients in Landmark group. In IV-ECG group, 97.3% of the catheter tip located at proper position (within 2 cm from junction of right atrium and superior vena cava, as compared to 88.8% of the tip position in Landmark group was proper. The difference was statistically significant (P < 0.05). There was no complication associated with the use of IV-ECG. CONCLUSION: IV-ECG is a safe and convenient method to help inexperienced operators placing TIVAD.
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Wang et al. (2011) conducted an observational in Patients receiving totally implantable venous access device (TIVAD) implantation (n=331). Intravenous electrocardiography (IV-ECG) vs. Surface landmarks was evaluated on Proper catheter tip position (within 2 cm from junction of right atrium and superior vena cava) (p=< 0.05). Intravenous electrocardiography use during totally implantable venous access device placement resulted in a higher rate of proper catheter tip position compared to surface landmarks (97.3% vs 88.8%, P<0.05).
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