Electrocardiographic-guided tip positioning technique for peripherally inserted central catheters in a Dutch teaching hospital: Feasibility and cost-effectiveness analysis in a prospective cohort study

Abstract

Implementation of electrocardiographic-guided tip positioning for peripherally inserted central catheter was safe and effective in this study and led to an improved high value and cost-conscious care.

Application of intracavitary ECG for positioning the totally implantable venous access port in the upper arm of cancer patients

“…Improper catheter placement not only prolongs the operation time but also increases the radiation exposure of patients and medical staff by repeated DSA fluoroscopy ( 26 ). The present study indicated that the intracavitary ECG-guided tip positioning technique is able to improve the accuracy of tip catheter placement and save operation time, thus reducing exposure to ionizing radiation due to repeated positioning.…”

“…The present study indicated that the intracavitary ECG-guided tip positioning technique is able to improve the accuracy of tip catheter placement and save operation time, thus reducing exposure to ionizing radiation due to repeated positioning. Considering the accuracy of intracardiac ECG localization at the tip of the central venous catheter and the influence of X-ray irradiation on patients, an increasing number of researchers suggested that X-ray examination should be cancelled after intracavitary ECG-guided tip positioning ( 26 , 27 ). However, this technology requires medical staff to have a high ability to analyse and interpret ECG.…”

The application of intracavitary electrocardiogram for tip location of femoral vein catheters in chemotherapy patients with superior vena cava obstruction

“…According to the previous research results, the rate of successful insertion at the first attempt of IC-ECG for tip of CVC was 95% to 100%, while that of X-ray was 80% to 92.3%. [12][13][14][15][16] The P wave is the expression of synchronized depolarization of RA and left atrium. The metal guide wires or saline column could lead to stable ECG, 11,13 and the metal guide wire inside the catheter was used as an intracavitary electrode in this study.…”

“…Tomaszewski et al 12 had studied that the average time from initiation of PICC procedure till the time to release intravenous therapy in the Sherlock 3CG Tip Confirmation System (TCS) group was shorter 142.39 min than X-ray group, and the staff satisfaction of the procedure was significantly greater in the Sherlock 3CG TCS group. Bloemen et al 14 had shown that IC-ECG location reduced the medical costs of patients due to decreased labor and fluoroscopy costs. Li et al 15 had reported that the anxiety level of patients at 24 h after catheterization in IC-ECG group was significantly lower than that in the X-ray group.…”

“…X-ray for locating the tip position of CVC has some limitations such as time-consuming, judgment delay, radiation exposure and less accuracy. 12 The IC-ECG location method with high accuracy assists in monitoring the position of the catheters in real-time through P wave changes, [13][14][15][16] and then realizes the integration of catheterization and catheters location. However, most of the studies focused on the application of IC-ECG location in upper extremity catheters, so our study intended to explore the clinical application effects of IC-ECG on catheter tip location in chemotherapy patients with femoral vein catheters.…”