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Endovascular electrocardiography to guide placement of totally implantable central venous catheters in oncologic patients.
MedLine Citation:
PMID:  21667460     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose: Appropriate tip position of totally implantable central venous catheters is essential in order to prevent catheter-related complications, in particular thrombosis. Endovascular electrocardiography is an economic and safe method to guide placement of catheters into the central veins. Although widely utilized, there is still lack of conclusive evidence about its efficacy. The aim of the study was to assess the efficacy and safety of endovascular electrocardiographic guided placement compared to the anthropometric method. Methods: Endovascular ECG was employed to guide electrocardiographic placement of a central venous catheter in a cohort of oncologic patients. The rate of correct placement and the incidence of catheter-related thrombosis were considered. Patients in which central venous catheters were inserted with the anthropometric technique were considered as control group. Results: The rate of correct placement was 91% and 50% for ECG-guided and anthropometric catheters (p<0.0001) respectively. None of the patients suffered from early insertion-related complications. The rate of catheter-related vascular thrombosis was lower for ECG-guided catheters (3.6% vs. 9.6%, n.s.), in particular for left-inserted catheters (0% vs. 33.3%, p=0.02). Conclusion: Endovascular electrocardiography was more effective than the anthropometric technique in placement of implantable central venous catheters and was associated with a lower incidence of catheter-related thrombosis, in particular for those inserted from the left-side.
Authors:
Cecilia Pelagatti; Gianluca Villa; Andrea Casini; Cosimo Chelazzi; Angelo Raffaele De Gaudio
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-30
Journal Detail:
Title:  The journal of vascular access     Volume:  -     ISSN:  1724-6032     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Critical Care, Section of Anesthesiology and Intensive Care, University of Florence, Florence - Italy.
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