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A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery

BACKGROUND AND AIMS: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth o...

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Autores principales: Barnwal, Neeraj Kumar, Dave, Sona T, Dias, Raylene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966350/
https://www.ncbi.nlm.nih.gov/pubmed/27512162
http://dx.doi.org/10.4103/0019-5049.186030
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author Barnwal, Neeraj Kumar
Dave, Sona T
Dias, Raylene
author_facet Barnwal, Neeraj Kumar
Dave, Sona T
Dias, Raylene
author_sort Barnwal, Neeraj Kumar
collection PubMed
description BACKGROUND AND AIMS: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth of central venous catheter (CVC) placement. METHODS: In a prospective randomised study of sixty patients of <12 years of age, thirty patients each were allotted randomly to two groups (ECG and landmark). After induction, central venous catheterisation was performed by either of the two techniques and position of CVC tip was compared in post-operative chest X-ray with respect to carina. Unpaired t-test was used for quantitative data and Chi-square test was used for qualitative data. RESULTS: In ECG group, positions of CVC tip were above carina in 12, at carina in 9 and below carina in 9 patients. In landmark group, the positions of CVC tips were above carina in 10, at carina in 4 and below carina in 16 patients. Mean distance of CVC tip in ECG group was 0.34 ± 0.23 cm and 0.66 ± 0.35 cm in landmark group (P = 0.0001). Complications occurred in one patient in ECG group and in nine patients in landmark group (P = 0.0056). CONCLUSION: Overall, landmark-guided technique was comparable with ECG technique. ECG-guided technique was more precise for CVC tip placement closer to carina. The incidence of complications was more in the landmark group.
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spelling pubmed-49663502016-08-10 A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery Barnwal, Neeraj Kumar Dave, Sona T Dias, Raylene Indian J Anaesth Original Article BACKGROUND AND AIMS: The complications of central venous catheterisation can be minimized by ensuring catheter tip placement just above the superior vena cava-right atrium junction. We aimed to compare two methods, using an electrocardiogram (ECG) or landmark as guides, for assessing correct depth of central venous catheter (CVC) placement. METHODS: In a prospective randomised study of sixty patients of <12 years of age, thirty patients each were allotted randomly to two groups (ECG and landmark). After induction, central venous catheterisation was performed by either of the two techniques and position of CVC tip was compared in post-operative chest X-ray with respect to carina. Unpaired t-test was used for quantitative data and Chi-square test was used for qualitative data. RESULTS: In ECG group, positions of CVC tip were above carina in 12, at carina in 9 and below carina in 9 patients. In landmark group, the positions of CVC tips were above carina in 10, at carina in 4 and below carina in 16 patients. Mean distance of CVC tip in ECG group was 0.34 ± 0.23 cm and 0.66 ± 0.35 cm in landmark group (P = 0.0001). Complications occurred in one patient in ECG group and in nine patients in landmark group (P = 0.0056). CONCLUSION: Overall, landmark-guided technique was comparable with ECG technique. ECG-guided technique was more precise for CVC tip placement closer to carina. The incidence of complications was more in the landmark group. Medknow Publications & Media Pvt Ltd 2016-07 /pmc/articles/PMC4966350/ /pubmed/27512162 http://dx.doi.org/10.4103/0019-5049.186030 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Barnwal, Neeraj Kumar
Dave, Sona T
Dias, Raylene
A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title_full A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title_fullStr A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title_full_unstemmed A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title_short A comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
title_sort comparative study of two techniques (electrocardiogram- and landmark-guided) for correct depth of the central venous catheter placement in paediatric patients undergoing elective cardiovascular surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966350/
https://www.ncbi.nlm.nih.gov/pubmed/27512162
http://dx.doi.org/10.4103/0019-5049.186030
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