The intracavitary ECG method for insertion of a tunneled dialysis catheter without using fluoroscopy

The Journal of Vascular Access
Seong ChoSung-Rok Kim

Abstract

Recently, there have been many reports that exact central vein catheter tip positioning was possible using intracardiac electrocardiographic (ECG) monitoring. Ultrasonic guidance in combination with intracardiac ECG monitoring may allow for a tunneled dialysis catheter to be inserted at the bedside without using fluoroscopy. Therefore we report on the intracavitary ECG method for insertion of a tunneled dialysis catheter with ultrasound guidance and the feasibility, safety, effectiveness, complications and limitations of this method. From April 2012 to June 2014, we evaluated 142 hemodialysis (HD) patients who were dialyzed by a tunneled dialysis catheter that was inserted using intracardiac ECG monitoring without fluoroscopic usage. We checked the intracardiac P wave and the point at which it gradually rose to the highest P wave morphology, we stopped inserting the catheter. Catheter flow during dialysis was adequate in 139 cases. There were three cases where it malfunctioned. Catheter malposition occurred in 6 out of 142 cases. The correct matching rate between the intracardiac ECG and chest posteroanterior (PA) view was 98.5%. No significant complications developed. To conclude, in this single-center study, the intracavitary...Continue Reading

References

Feb 10, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marcel C WeijmerPiet M ter Wee
Jan 18, 2006·British Journal of Anaesthesia·P A Stonelake, A R Bodenham
Oct 19, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Raynel Kinney, Raynel Kinney
Mar 9, 2010·Journal of Electrocardiology·Brigham SmithAndrew D Michaels
Jun 15, 2011·The Journal of Vascular Access·Mauro PittirutiGiancarlo Scoppettuolo

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Citations

Oct 10, 2018·Current Opinion in Critical Care·Thibaut GirardotThomas Rimmelé
Oct 16, 2018·Journal of X-ray Science and Technology·Ketong WuBo Zhang
Mar 13, 2021·The Journal of Vascular Access·Zi Yun ChangChristopher Ch Leo
Jul 14, 2021·The Journal of Vascular Access·Mariana Garcia-LealRodrigo Enrique Elizondo-Omaña

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