Capozzoli Giuseppe, Accinelli Gino, Fabbro Loris, Pedrazzoli Roberta, Auricchio Franco
Anesthesia and Intensive Care Unit, Bolzano Central Hospital, Italy.
J Vasc Access. 2012 Jul-Sep;13(3):393-6. doi: 10.5301/jva.5000065.
Intra-cavitary electrocardiography (ECG) is a well-known method for correct positioning of the tip of central venous catheters (CVC). A significant increase in the P wave, as registered by the intra-cavitary electrode, signals the entrance of the catheter into the right atrium.
In this prospective observational study, 155 consecutive oncologic patients were enrolled for cannulation of the right or left internal jugular vein for insertion of a tunneled Groshong catheter. In 150 patients the tip was positioned by means of intracavitary ECG. Five patients with atrial fibrillation (N=4) or pacemaker in place (N=1) were excluded from the study. As the P-wave amplitude began to increase, the catheter was secured in that position and the insertion depth was registered.
Intra-cavitary ECG was always apt to detect the increase in the P wave. On the post-operative chest x-ray all Groshong catheters except two were in the correct position.
The need for chest x-ray or fluoroscopy may be virtually eliminated by using the ECG technique.
腔内心电图（ECG）是一种用于正确定位中心静脉导管（CVC）尖端的知名方法。腔内电极记录到的P波显著增大表明导管进入右心房。
在这项前瞻性观察研究中，连续纳入155例肿瘤患者，通过右侧或左侧颈内静脉进行隧道式Groshong导管插管。150例患者通过腔内心电图定位导管尖端。5例心房颤动患者（4例）或植入起搏器患者（1例）被排除在研究之外。当P波振幅开始增加时，将导管固定在该位置并记录插入深度。
腔内心电图总能检测到P波增大。术后胸部X线检查显示，除两根导管外，所有Groshong导管位置均正确。
使用心电图技术几乎可以消除对胸部X线或荧光透视的需求。
