Position control of central venous catheters with intraatrial ECG measurement an alternative to radiological methods

Abstract

Introduction. Radiologic modalities are usually applied to control the position of central venous catheters. In a retrospective study we analyzed our experience of intraatrial EKG measurement for positioning the catheter tip. Material and methods. All catheter positioning carried out between 1995 and 1999 were included in the study. The intraatrial ECG was carried out using a special alpha-card system. Either the intraoperative fluorscopy or the postoperative x-ray were used as reference methods for controlling the position of the catheter tip. Results. 140 catheterpositioning could be evaluated. 84 (60%) were positioned using alpha-card and 56 (40%) under fluorscopy. Only a single case of malpositioning was found in the postoperative x-ray, whereby here an accidential dislocation could not be excluded. Thus the sensitivity and specifity of the catheterpositioning using intracardial ECG measurement was found to be over 95%. Conclusion. The intraatrial ECG application for positioning centralvenous catheters has due to its high reliability and practicality more and more replaced the radiological method.