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Ecg and PICC

Qi-Ying Ling, Hong Chen, Min Tang, Yi Qu, Bin-Zhi Tang
OBJECTIVE: To study the efficiency of electrocardiogram (ECG) monitor for positioning the catheter tip in the placement of peripherally inserted central catheter (PICC) in neonates. METHODS: A total of 160 neonates who were admitted to the neonatal intensive care unit (NICU) from January 2015 to December 2017 and underwent the PICC placement via the veins of upper extremity were enrolled. They were randomly divided into an observation group and a control group, with 80 neonates in each group...
May 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Lian-Juan Zhou, Hong-Zhen Xua, Mei-Fang Xu, Yan Hu, Xiao-Fang Lou
OBJECTIVE: To explore the clinical application of the intracavitary electrocardiogram (IC-ECG) guided Peripherally Inserted Central Catheter (PICC) tip placement among neonates. BACKGROUND: the ECGs of neonates are difficult to perform and their wave shapes are of doubtful accuracy due to various interfering factors. METHOD: 115 neonates were admitted to perform PICC guided by IC-ECG. Logistic regression was performed to analyze all possible influencing factors of the accuracy from the tip placement...
2017: Open Medicine (Warsaw, Poland)
Lianjuan Zhou, Hongzhen Xu, Jianfeng Liang, Meifang Xu, Jun Yu
Correct tip location is crucial for a peripherally inserted central catheter (PICC) to maximize the effects of central venous infusion. However, it is difficult to place the tip in a correct location in neonates because of the unreliable estimated length by surface landmark. Therefore, we evaluated the feasibility and safety of an improved intracavitary electrocardiogram (IC-ECG) technique in guiding PICC placement in neonates based on the ratios of P/R wave amplitudes on IC-ECG. The results showed that all of the 32 neonates whose PICCs had been successfully placed and correct tip position verified by chest radiography acquired qualified P wave on IC-ECG...
October 2017: Journal of Perinatal & Neonatal Nursing
Vineet Chopra, Latoya Kuhn, David Ratz, Suzanne Winter, Peter J Carr, David Paje, Sarah L Krein
BACKGROUND: While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings. METHODS: Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement...
May 15, 2017: Journal of Vascular Access
Ling Yuan, Rongmei Li, Aifeng Meng, Yuling Feng, Xiancui Wu, Yiqun Yang, Ping Chen, Zhenzhu Qiu, Jing Qi, Chuanying Chen, Jia Wei, Minyi Qin, Weiwei Kong, Xiangyu Chen, Wei Xu
BACKGROUND: Intracavitary electrocardiogram (IC ECG) guidance emerges as a new technique for peripherally inserted central catheters (PICCs) placement and demonstrates many potential advantages in recent observational studies. AIMS: To determine whether IC ECG-guided PICCs provide more accurate positioning of catheter tips compared to conventional anatomical landmarks in patients with cancer undergoing chemotherapy. METHODS: In this multicenter, open-label, randomized controlled study (ClinicalTrials...
2017: PloS One
Stefano Elli, Luigi Cannizzo, Alessia Marini, Silvia Porcarelli, Filippo Azzarone, Roberto Fumagalli, Giuseppe Foti, Alberto Lucchini
. Evaluation of tip location reliability of intraprocedural ECG vs. chest Xrays in PICC placement. INTRODUCTION: Among the methods to assess the correct positioning of the tip of central venous catheters, the ECG method is safe and reliable. AIM: To compare the reliability of tip location by intraprocedural ECG and post-procedural radiological examination as implemented in routine care in a tertiary hospital PICC Team. METHODS: 119 PICCs positioned by the Monza hospital PICC Team were examined positioned by either ECG technique or post procedural x-rays technique...
October 2016: Assistenza Infermieristica e Ricerca: AIR
Eva Bedford, Dee Waterhouse
Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs)...
January 26, 2017: British Journal of Nursing: BJN
J M Slagowski, Dap Dunkerley
PURPOSE: To obtain ECG-gated CT images from truncated projection data acquired with a C-arm based inverse geometry fluoroscopy system, for the purpose of cardiac chamber mapping in interventional procedures. METHODS: Scanning-beam digital x-ray (SBDX) is an inverse geometry fluoroscopy system with a scanned multisource x-ray tube and a photon-counting detector mounted to a C-arm. In the proposed method, SBDX short-scan rotational acquisition is performed followed by inverse geometry CT (IGCT) reconstruction and segmentation of contrast-enhanced objects...
June 2016: Medical Physics
Gemma Oliver, Matt Jones
In 2011, the vascular access team at East Kent Hospitals University NHS Foundation Trust safely and successfully incorporated the use of electrocardiogram (ECG) guidance technology for verification of peripherally inserted central catheters (PICC) tip placement into their practice. This study, 5 years on, compared the strengths and limitations of using this ECG method with the previous gold-standard of post-procedural chest X-ray. The study was undertaken using an embedded case study approach, and the cost, accuracy and efficiency of both systems were evaluated and compared...
October 27, 2016: British Journal of Nursing: BJN
Ruiyi Zhao, Chunfang Chen, Jingfen Jin, Komal Sharma, Nan Jiang, Yingqin Shentu, Xingang Wang
The use of peripherally inserted central catheters (PICCs) provides important central venous accesses for clinical treatments, tests and monitoring. Compared with the traditional methods, intracardiac electrocardiogram (ECG)-guided method has the potential to guide more accurate tip positioning of PICCs. This study aimed to clinically evaluate the effectiveness of an intracardiac ECG to guide the tip positioning by monitoring characteristic P-wave changes. In this study, eligible patients enrolled September 2011 to May 2012 according to the inclusion and exclusion criteria received the catheterization monitored by intracardiac ECG...
June 2016: International Journal of Nursing Practice
Yan-Jin Liu, Lei Dong, Xiao-Ping Lou, Jin-Hong Miao, Xiu-Xia Li, Xiao-Jing Li, Jing Li, Qian-Qian Liu, Zhi-Wei Chang
OBJECTIVE: To evaluate ECG-aided tip localization of peripherally inserted central catheter (PICC) in the patients with cancer. METHODS: Between September and December 2014, 170 patients undergoing PICC were divided into observation group and control group (each group with 85 patients). In observation group, patients received ECG-aided tip localization of PICC. In control group, PICC was performed with conventional method. After PICC was performed, all patients took orthophoria chest radiograph (OCR) to check whether the tip position of PICC was appropriate...
2015: International Journal of Clinical and Experimental Medicine
Megan Dale, Ailish Higgins, Grace Carolan-Rees
In current clinical practice, peripherally inserted central catheters (PICCs) are typically inserted using external anatomical measurements and a confirmatory chest X-ray, or using fluoroscopy. The Sherlock 3CG(®) Tip Confirmation System (TCS) allows magnetic tracking of the PICC tip during insertion and confirmation of the final location using ECG, meaning that most patients will not require a chest X-ray or fluoroscopy. The Sherlock 3CG(®) TCS was evaluated in 2014 by the UK National Institute for Health and Care Excellence (NICE) as part of the Medical Technologies Evaluation Programme...
February 2016: Applied Health Economics and Health Policy
Peter R Bream, Everett Gu
We are currently in the midst of a worldwide obesity epidemic, including in patients with end-stage kidney disease. Placing hemodialysis catheters is a particular challenge in patients with extreme obesity. Here we describe the merging of two technologies to place catheters in patients who are too heavy (over 225 kg) to be placed safely on a procedure table for fluoroscopic guidance. The first technology is ECG-guided placement of catheters, well established for guidance of peripherally inserted central catheters (PICCs) and tunneled and nontunneled central venous catheters...
September 2015: Kidney International
Francesco Baldinelli, Giuseppe Capozzoli, Roberta Pedrazzoli, Natascia Marzano
PURPOSE: The purpose of this study is to verify as early as possible the correct positioning of the peripherally inserted central catheter (PICC) tip in order to reduce complications due to possible malpositioning. The ECG-guided technique proved to be reliable, easy to carry out, straightforward, low-cost and allows us to recognize an incorrect or a suboptimal positioning throughout the procedure. The purpose of this study is to compare two methods used during the PICC insertion so as to prevent catheter malpositioning; the first study estimates the catheter length by the landmark method (based on cutaneous anatomical landmarks, CALs) with the addition of the postprocedural verification of tip location by chest X-Ray (CxR), whereas the second method of intraprocedural tip location is based on the observation of the morphological variations of the P wave (ECG-guided technique) with the addition of the postprocedural verification by CxR...
September 2015: Journal of Vascular Access
Gemma Oliver, Matt Jones
Recently there has been an increase in evidence that the tip position of a peripherally inserted central catheter (PICC) needs to be accurately placed in the lower third of the superior vena cava at the junction with the right atrium in order to minimise potential complications ( Royal College of Nursing, 2010 ; Infusion Nurses Society, 2011 ). The current 'gold standard' practice of performing a chest X-ray post-insertion of PICC can be fraught with complications with regard to accurately placing the PICC in this position...
October 22, 2014: British Journal of Nursing: BJN
Giordano Perin, Maria-Grazia Scarpa
PURPOSE: The purpose of this study is to analyse literature related to the position of centrally inserted central venous catheters and to review topics related to assessment of tip position of those catheters in children. Applications of specific techniques to PICCs (Periferally Inserted Central Catheters) and umbilical venous catheter will also be reviewed. METHODS: Analysis of 68 original manuscripts, 42 specifically related to the paediatric population, 26 related to the adult population...
March 2015: Journal of Vascular Access
Francesca Rossetti, Mauro Pittiruti, Massimo Lamperti, Ugo Graziano, Davide Celentano, Giuseppe Capozzoli
PURPOSE: The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. METHODS: We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals...
March 2015: Journal of Vascular Access
Mauro Pittiruti, Alessandro Emoli, Patrizia Porta, Bruno Marche, Rosa DeAngelis, Giancarlo Scoppettuolo
PURPOSE: Few randomized studies have investigated the impact of valved and non-valved power-injectable peripherally inserted central catheters (PICCs) in terms of incidence of occlusion, infection, malfunction and venous thrombosis. METHODS: We have prospectively compared three types of third-generation polyurethane PICCs. One hundred and eighty adult patients candidate to chemotherapy were randomized into three groups: power-injectable PICCs with Solo-2 proximal valve (Bard); power-injectable PICCs with PASV (Pressure Activated Safety Valve) proximal valve (Navilyst); and non-valved power-injectable PICCs (Medcomp)...
November 2014: Journal of Vascular Access
Gemma Oliver, Matt Jones
Performing a chest x-ray after insertion of a peripherally inserted central catheter (PICC) is recognised as the gold standard for checking that the tip of the catheter is correctly positioned in the lower third of the superior vena cava at the right atrial junction; however, numerous problems are associated with this practice. A recent technological advancement has been developed that utilises changes in a patient's electrocardiograph (ECG) recorded from the tip of the PICC as a more reliable method. This evaluation discusses how a vascular access team in a large acute NHS Trust safely and successfully incorporated the use of ECG guidance technology for verification of PICC tip placement into their practice...
July 25, 2013: British Journal of Nursing: BJN
Gloria Ortiz-Miluy, Carmen Sánchez-Guerra
OBJECTIVE: To evaluate the applicability, feasibility and accuracy of the IC-ECG with column of saline technique for verifying the final tip position of peripherally inserted central catheters (PICC) by specialist nurses. METHOD: A total of 99 consecutive PICC were inserted. Patients with no superficial ECG P wave, atrial fibrillation, or a pacemaker were excluded. The IC-ECG technique was performed on 84 patients. A chest x-ray was performed after insertion in all cases, in order to compare images with IC-ECG...
July 2013: Enfermería Clínica
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