Anesth Analg 2007; 105:1511-
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000287013.96196.5b
LETTER TO THE EDITOR
Atrial Electrocardiogram for Verification of Correct Central Venous Catheter Placement
L. Saager, MD,
E. Wiesner, MD,
A. Rothhammer, MD, PhD, and
G. Pestel, MD
Institut für Anaesthesiologie und Intensivmedizin; Leopoldina Krankenhaus der Stadt Schweinfurt gGmbH; Gustav Adolf Str. 8; Schweinfurt, Germany; lsaager{at}aol.com (Saager, Wiesner, Rothhammer)
Klinik und Poliklinik für Anästhesiologie; Inselspital; Bern, Switzerland (Pestel)
To the Editor:
Gebhard et al. (1) described verification of central venous catheter placement using atrial electrocardiogram (ECG), a technique described and introduced into clinical practice more than two decades ago (2,3). The majority of central venous catheters investigated by Gebhard et al. were inserted via the right internal jugular vein. Our own results of 1200 single-lumen central venous catheters, inserted via basilic or cephalic veins, show a rate of 95.5% correct placements, if guided by atrial ECG (4). Both results strengthen the already existing data on successful ECG-guided placement of central venous catheters via central and peripheral veins. We would also like to draw the authors' attention to a method published by Engelhardt et al. (5) who describe a technique that allows for ECG-guided placement of central venous catheters even in patients with atrial fibrillation. Reduced exposure to radiograph and timely correction of misplaced catheters should be enough reasons to establish this method as a clinical routine.
REFERENCES
- Gebhard RE, Szmuk P, Pivalizza EG, Melnikov V, Vogt C, Warters RD. The accuracy of electrocardiogram-controlled central line placement. Anesth Analg 2007;104:65–70[Abstract/Free Full Text]
- Martin JT. Neuroanesthetic adjuncts for patients in the sitting position. 3. Intravascular electrocardiography. Anesth Analg 1970;49:793–808[Free Full Text]
- Baar H, Danhauser I, Rothhammer A. Lagekontrolle zentralvenoser Katheter mit dem intrakardialen EKG. Eine Darstellung der Methode und ihrer Vorzuge gegenuber der Rontgen-Kontrolle. Fortschr Med 1984;102:755–6[Web of Science][Medline]
- Saager L, Wiesner E, Pestel G, Schönfeld T, Rothhammer A. Central venous catheters placed via peripheral veins—a forgotten technique? Crit Care Med 2005;33:A87
- Engelhardt W, Sold M, Helzel MV. ECG-controlled placement of central venous catheters in patients with atrial fibrillation. Anaesthesist 1989;38:476–9[Web of Science][Medline]
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R. E. Gebhard
Atrial Electrocardiogram for Verification of Correct Central Venous Catheter Placement
Anesth. Analg.,
November 1, 2007;
105(5):
1511 - 1511.
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