Department of Anesthesiology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Artif Organs. 2022 Jun;25(2):105-109. doi: 10.1007/s10047-021-01293-1. Epub 2021 Sep 15.
Recently, the Sherlock 3CG™ Tip Confirmation System, including a magnetic tracking system and an intracavitary electrocardiography guidance system, has been introduced for bedside peripherally inserted central catheter (PICC) insertion. Magnetic field sources interfere with the magnetic tracking system. Electromagnetic interference of the ventricular assist device (VAD) has already been reported with various devices but not on Sherlock 3CG™. We assessed the availability of the magnetic tracking system in patients with and without a VAD during Sherlock 3CG™ insertion and evaluated the rate of optimal PICC tip position. We retrospectively reviewed 99 patients who had undergone PICC insertion using Sherlock 3CG™ on the bedside at our institutional intensive care unit from February 2018 to December 2020. Patients were divided into groups with and without a VAD. The availability of magnetic navigation and the success rate of optimal catheter tip position in each group were assessed. Among 87 cases analyzed, there were 12 and 75 cases with a VAD and without a VAD, respectively. The availability of magnetic navigation during Sherlock 3CG™ insertion was significantly lower in the group with a VAD [4/12 (33%) with VAD vs. 72/75 (96%) without VAD, P < 0.001]. In addition, the rate of optimal PICC tip position was also significantly lower in the group with a VAD [6/12 (50%) vs. 63/75 (84%), P = 0.015] The VAD significantly led to magnetic tracking system failure due to its electromagnetic interference during Sherlock 3CG™ insertion and significantly reduced the success rate of PICC insertions in the optimal position.
最近，Sherlock 3CG™ 尖端确认系统，包括一个磁场跟踪系统和一个心腔内心电图引导系统，已经被引入用于床边外周中心静脉导管（PICC）置管。磁场源会干扰磁场跟踪系统。已经有报道称，各种设备会对心室辅助装置（VAD）产生电磁干扰，但 Sherlock 3CG™ 则没有。我们评估了在有和没有 VAD 的患者中，Sherlock 3CG™ 插入期间磁场跟踪系统的可用性，并评估了最佳 PICC 尖端位置的成功率。我们回顾性地分析了 2018 年 2 月至 2020 年 12 月在我们机构重症监护病房床边使用 Sherlock 3CG™ 进行 PICC 置管的 99 例患者。患者分为有 VAD 和无 VAD 两组。评估了每组中磁导航的可用性和最佳导管尖端位置的成功率。在分析的 87 例病例中，有 VAD 的病例有 12 例，无 VAD 的病例有 75 例。在 Sherlock 3CG™ 插入过程中，有 VAD 的组中磁场导航的可用性明显较低[有 VAD 的 12 例中有 4 例（33%），无 VAD 的 75 例中有 72 例（96%），P<0.001]。此外，有 VAD 的组中最佳 PICC 尖端位置的比例也明显较低[有 VAD 的 12 例中有 6 例（50%），无 VAD 的 75 例中有 63 例（84%），P=0.015]。VAD 在 Sherlock 3CG™ 插入过程中因其电磁干扰而显著导致磁跟踪系统故障，并显著降低了最佳位置 PICC 插入的成功率。
