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KMID : 1034120070010010019
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Journal of Clinical Nutrition
2007 Volume.1 No. 1 p.19 ~ p.22
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P Wave Change Ratio; A Technique for the Central Venous Catheterization
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Lee Do-Sang
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Abstract
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Purpose: This study examined the value of an electrocardiogram (ECG) in central venous catheterization (CVC) for nutrition support.
Methods: The rates of change in the P wave and the QRS wave at limb lead II before and after catheter insertion were evaluated in 442 patients who underwent CVC with an ECG. After insertion, a plain chest X-ray was checked to confirm the location of 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 and the QRS wave was ＜2.0 and ＜1.4, respectively. The sensitivity and the specificity of the P wave ＞2.0 were 95% and 100%, respectively. The sensitivity and the specificity of the QRS wave ＞1.4 were 90% and 100%, respectively.
Conclusion: In central venous catheterization, ECG can be a useful method, and the normal position of the catheter tip can be estimated using the rate of change in the P wave ＞2.0 or the rate of change in the QRS wave ＞1.4.
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KEYWORD
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Central venous catheterization, Electrocardiogram
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