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Anesth Analg 2006;103:435-438
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000223688.12751.b8

NEUROSURGICAL ANESTHESIA

Accurate Placement of the Right Atrial Air Aspiration Catheter: A Descriptive Study and Prospective Trial of Intravascular Electrocardiography

Randall H. E. Kerr, MD, and Richard L. Applegate, II, MD

Diplomat of the American Board of Anesthesiology.

Address correspondence and reprint requests to Randall H. E. Kerr, MD, Department of Anesthesiology, Loma Linda University Medical Center, 11234 Anderson St., Loma Linda, CA 92354. Address e-mail to kerr.randall{at}gmail.com.

Appropriate positioning of the right atrial air aspiration catheter is critical to successful aspiration of air. The intravascular electrocardiography patterns currently used to position the right atrial air aspiration catheter have not been validated by echocardiography. In 10 patients, using simultaneous transesophageal echocardiography and intravascular electrocardiography, we found that the largest monophasic P wave without a biphasic component correlated with the right atrial-superior vena cava junction. Using this pattern, we performed a prospective trial on 10 subjects and demonstrated appropriate positioning in only 8. This preliminary study suggests that intravascular electrocardiography may not yield appropriate positioning in all patients.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.