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LETTER TO THE EDITOR

Atrial Electrocardiogram for Verification of Correct Central Venous Catheter Placement

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

1. 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]
2. Martin JT. Neuroanesthetic adjuncts for patients in the sitting position. 3. Intravascular electrocardiography. Anesth Analg 1970;49:793–808[Free Full Text]
3. 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]
4. 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
5. 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]

This article has been cited by other articles:

				R. E. Gebhard Atrial Electrocardiogram for Verification of Correct Central Venous Catheter Placement Anesth. Analg., November 1, 2007; 105(5): 1511 - 1511. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Saager, L. Articles by Pestel, G. Search for Related Content PubMed PubMed Citation Articles by Saager, L. Articles by Pestel, G.