6th World Congress on Vascular Access 2021

Description and analysis of the intracavitary electrocardiogram at the insertion of the peripheral central insertion catheter (PICC) in the adult patient.

INTRODUCTION

The functioning of the PICC depends on the tip position.

The intracavitary electrocardiogram (EKG-IC) locates the tip of the catheter by observing cardiac electrical activity from an intracavitary electrode.

OBJECTIVE

Evaluate the tip position of the PICC by observing morphological variations of the p wave, QRS complex, and T wave of the intracavitary electrocardiogram.

METHOD

Descriptive, clinical series study.

Sampling: convenience –selected patients requiring PICC and chest X-ray at Fundación Jimenez Díaz

DISCUSSION

Tip location is an indicator of quality and safety in the insertion of PICC. The ECG-IC is a safe and accuracy technique.

CONCLUSIONS

The p wave and QRS complex have a clear increase in amplitude or height in the EKG-IC, while the T wave has hardly any modifications.

The p and QRS waves grow according to the catheter approaches the right atrium in the ECG-IC, that is, the catheters located in Zone B and C have p and QRS waves higher height than the catheters in Zone A

§EKG-IC changes that happen in the p wave and the QRS complex provide information about the catheter's path and position, while the T wave does not provide any information.

1.Barton A. Confirming PICC tip position during insertion with real-time information. British Journal of Nursing. 2015;25 (Suppl)S17-21

2.Johnston A, Bishop SM, Martin L, et al. Defining peripherally inserted central catheter tip position and an evalutation of insertion in one unit. Anaesthesia. 2013; 22(5):484-19

3.La Greca A.Evaluation Techniques of the PICC tip placement. Peripherally Inserted Central Catheters. Peripheral inserted central venous catheter. Ed Sandrucci S & Mussa B. Milan: Springer.2014;(7):63-83

4. Dale M, Higgins A, Carolan-Rees G Sherlock® 3CG tip confirmation system for placement of peripherally inserted central catheters: A NICE medical technology guidance. Applied health economics and health policy. 2015; 14:41-49.

5. Pittiruti M, La Greca A. Scoppettuolo G. The electrocardiographic method for positioning the tip of central venous catheters. JVasc Access 2011:12(4)289-91. (18)

6th World Congress on Vascular Access 2021

Description and analysis of the intracavitary electrocardiogram at the insertion of the peripheral central insertion catheter (PICC) in the adult patient

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