The electrocardiographic method for positioning the tip of central venous access device

Background: The electrocardiogram-based insertion method is non-radiative, allowing real-time positioning verification and reducing the need for postoperative repositioning. Methods: Relevant databases published from January 1990 to January 2019 in PubMed, Web of Knowledge, Medline and Ovid’s databa...

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Bibliographic Details
Published in:The Journal of Vascular Access 2020-09, Vol.21 (5), p.589-595
Main Authors: Yu, Yanfen, Yuan, Lingling
Format: Article
Language:English
Subjects:
Adult
Anatomic Landmarks
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - instrumentation
Catheters, Indwelling
Central Venous Catheters
Electrocardiography - adverse effects
Female
Humans
Infant, Newborn
Male
Middle Aged
Punctures
Radiation Dosage
Radiation Exposure - prevention & control
Radiography, Interventional - adverse effects
Risk Assessment
Risk Factors
Treatment Outcome
Veins - diagnostic imaging
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Summary:Background: The electrocardiogram-based insertion method is non-radiative, allowing real-time positioning verification and reducing the need for postoperative repositioning. Methods: Relevant databases published from January 1990 to January 2019 in PubMed, Web of Knowledge, Medline and Ovid’s database were searched, comparing the effectiveness of electrocardiogram-guided catheter tip positioning (electrocardiogram-guided group) and the landmarks-guided insertion plus chest X-ray confirmation (landmarks-guided group). The primary outcome was accurate catheter tip placement and the secondary outcomes were complications. Results: A total of 13 studies were finally included with a total of 4988 patients, of whom 2789 cases were in the electrocardiogram-guided group and 2199 cases received landmarks-guided insertion plus chest X-ray. Compared with the landmarks-guided group, our meta-analysis showed that the electrocardiogram-guided group had a higher success rate of tip placement (odds ratio = 0.21, 95% confidence interval = 0.14–0.34, p 
ISSN:1129-7298
1724-6032
DOI:10.1177/1129729819874986