Central Vein Catheterization with an Electrocardiogram

Lee, Do Sang; Son, Chang Hee; Baek, Jong Min; Sung, Gi Young; Kim, Wook; Park, Il Young; Won, Jong Man

Abstract

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.