Correct positioning of central venous catheters using a new electric method

The Journal of Vascular Access
Maurits K KoningsAnton J van Boxtel

Abstract

In order to find the correct final position of the tip of a central venous catheter, we have developed a new electric method (the Proximity of Cardiac Motion (PCM) method), designed to work in tandem with the existing ECG-based method. A small, patient-safe, high-frequency current is fed through the catheter (via the saline-filled lumen of the catheter, or a stylet). Simultaneously, the resulting voltage is measured by two electrodes on the frontal thoracic skin. The catheter tip hence functions as a current source inside the vasculature. The cardiac motion produces a variation in the amplitude of the measured voltage in the rhythm of the cardiac cycle, and the strength of this oscillatory variation is proportional to the strength of the incident current field on the heart, which is a rapidly decaying function of the distance between the catheter tip and the cavoatrial junction (CAJ). Hence the strength of this oscillatory variation is a strong indicator for the proximity of the catheter tip with respect to the CAJ. The new method has been tested in an animal model, yielding an average final position of the catheter tip of 2.1 cm above the CAJ, with a maximum deviation of 0.5 cm. We conclude that the new PCM method can be combi...Continue Reading

References

Jun 15, 2011·The Journal of Vascular Access·Mauro PittirutiGiancarlo Scoppettuolo

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Citations

Jul 7, 2015·Biomedizinische Technik. Biomedical Engineering·Annemoon M TimmermanMaurits K Konings
Jan 20, 2017·British Journal of Anaesthesia·D K Tempe, S Hasija

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