Document Detail

Central venous catheter placement in children: evaluation of electrocardiography using J-wire.
MedLine Citation:
PMID:  10597553     Owner:  NLM     Status:  MEDLINE    
Misplacement of a central venous catheter may lead to myocardial perforation and dysrhythmia. Atrial electrocardiography (ECG) through a saline column is an effective but complex method to determine the accurate location of catheters. We evaluated a simplified variant of this technique using the guidewire as an internal electrode in 23 children (5-16 years old) undergoing spinal surgery. Catheters were placed using a Seldinger technique after jugular or subclavian venous puncture. Each time the operator recognized the atrial signal, the catheter was found to be correctly placed on the chest radiograph (20/23). In three patients, the atrial signal was not obtained. A technical error was responsible in one case whereas the two others were related to aberrant migrations of the catheter either into a subclavian vein or into the pleura. In this latter case, the complication was unrecognized on the first radiograph despite malposition having been predicted by atrial ECG. We conclude that a method using atrial ECG guidance is sensitive and specific, and may be an alternative to the classical chest radiograph to detect accurate placement of central venous catheters in children.
L Simon; A Teboul; N Gwinner; G Boulay; S Cerceau-Delaporte; J Hamza
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  9     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  1999  
Date Detail:
Created Date:  2000-01-27     Completed Date:  2000-01-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  501-4     Citation Subset:  IM    
Service d'anesthésiologie pédiatrique, Hôpital St Vincent de Paul, Paris, France.
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MeSH Terms
Catheterization, Central Venous / methods*
Electrocardiography / instrumentation*
Evaluation Studies as Topic
Prospective Studies
Radiography, Thoracic
Scoliosis / surgery
Spine / surgery*

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