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KMID : 0371320040670030231
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Journal of the Korean Surgical Society
2004 Volume.67 No. 3 p.231 ~ p.234
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Central Vein Catheterization with an Electrocardiogram
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Lee Do-Sang
Sohn Chang-Hee
Baek Jong-Min
Sung Gi-Young
Kim Wook
Park Il-Young
Won Jong-Man
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Abstract
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PURPOSE: This study analyzed the value of an electrocardiogram (ECG) using an arterial pulsator in central vein catheterization (CVC).
METHODS: In 442 patients who underwent CVC with an ECG and an arterial pulsator, this study evaluated the rates of change in the P wave and the QRS wave at the limb lead II before and after insertion. After insertion, a plain chest X-ray was checked in order to locate the catheter tip.
RESULTS: After catheterization, the P wave and the QRS wave increased together at 97% but the P wave (change rate: 0.5~21.0) was more sensitive than the QRS wave (change rate: 0.5~5.8). For an abnormal location (3%), the rate of change in the P wave was <2.0 and that of the QRS wave was <1.4. The sensitivity and the specificity of the P wave >2.0 were 95% and 100%, and those of the QRS wave >1.4 were 90% and 100%.
CONCLUSION: In central vein catheterization, an electrocardiogram with an arterial pulsator can be a useful method, and the normal position of the catheter tip can be estimated by using a rate of change in the P wave >2.0 or a rate of change in QRS wave >1.4.
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