腔内心电图引导下经外周静脉置入中心静脉导管留置中对导管尖端位置影响的回顾性病例对照研究。
Effects of indwelling centrally inserted central catheter on tip location of peripherally inserted central catheter with intracavitary electrocardiogram guidance: A retrospective case-control study.
机构信息
Department of Clinical Nutrition, Peking Union Medical College Hospital, Beijing, China.
Department of Nursing, Peking Union Medical College Hospital, Beijing, China.
出版信息
J Vasc Access. 2023 May;24(3):379-384. doi: 10.1177/11297298211015088. Epub 2021 Jul 23.
BACKGROUND
Intracavity electrocardiogram (IC-ECG) guidance is an effective technology for monitoring the tip locations of centrally inserted central catheters (CICCs) and peripherally inserted central catheters (PICCs). However, for patients with an indwelling CICC, there has been no study on whether the CICC affects PICC tip positioning with IC-ECG guidance.
METHODS
Thirty people with a CICC requiring PICC insertion, matched with age to controls without a CICC. The stability of IC-ECG waveforms, the amplitude of P-waves, and the accuracy of PICC tip location were compared.
RESULTS
There was no significant difference in the stability of the IC-ECG waveforms (χ = 0.22, = 0.64). The amplitudes of baseline P-waves and ideal P-waves also showed no significant difference (1 = 0.06, 1 = 0.96, 2 = 0.80, 2 = 0.43). Neither the accuracy of tip location (χ = 1.40, = 0.50) nor the distance of PICC tip ( = -0.03, = 0.98) were significantly different.
CONCLUSION
For patients with an indwelling CICC, the position of PICC tip can be accurately determined by the dynamic changes in the P-wave amplitude.
背景
心腔内心电图（IC-ECG）引导是监测中心静脉导管（CICC）和外周插入中心静脉导管（PICC）尖端位置的有效技术。然而，对于留置 CICC 的患者，尚未研究 IC-ECG 引导是否会影响 PICC 尖端位置。
方法
30 名需要插入 PICC 的 CICC 患者与无 CICC 的对照组年龄匹配。比较了 IC-ECG 波形的稳定性、P 波幅度和 PICC 尖端位置的准确性。
结果
IC-ECG 波形的稳定性无显著差异（χ²=0.22，P=0.64）。基线 P 波和理想 P 波的幅度也无显著差异（t=0.06，P=0.96，t²=0.80，P=0.43）。尖端位置的准确性（χ²=1.40，P=0.50）和 PICC 尖端距离（t=-0.03，P=0.98）均无显著差异。
结论
对于留置 CICC 的患者，P 波幅度的动态变化可准确确定 PICC 尖端位置。
Zotero 插件