[Positioning of Umbilical Vein Catheter With ECG-guided Technique: Randomized Study]

Acta Biomed Ateneo Parmense. 2000;71 Suppl 1:647-50.
[Article in Italian]

Abstract

Goal: To evaluate the effectiveness of electrocardiography-guided technique to aid in the correct positioning of umbilical vein catheters.

Design: A prospective, randomized controlled study.

Methods: Term and preterm newborns who required an umbilical venous catheter were managed by an ECG-guided technique (group A) or by a conventional method (group B). Correct positioning was defined by a chest-X-ray when the catheter tip was located above the diaphragm and outside the right atrium. For the ECG-guided technique we utilized a conductive device Vygocard (Medival, Padova) inserted in a 3-way stopcock connected with the catheter. The catheter was inserted under ECG observation until the appearance of a tall P-wave in lead III, which indicated the tip was within the right atrium. The catheter was then withdrawn until the P wave size returned to normal.

Results: We enrolled 44 patients (16 F, 28 M). Median gestational age (GA) and birth weight (BW) were 34 weeks (range 26-41) and 2130 g. (590-3870), respectively. Sex distribution, GA, BW and Apgar scores were not different between patients in group A (n = 22) and group B (n = 22). Catheters could not be advanced till the estimated insertion depth in 11 patients (A = 5, B = 6). In the remaining 33 patients, correct tip placement was more frequent in group A (88%) compared with group B (50%) (p = 0.021 by Fisher's exact test). No side effects specific to the ECG-guided method were noted.

Conclusions: The ECG-guided technique seems to be a safe and effective method for the proper placement of umbilical vein catheters in newborns.

Publication types

  • Clinical Trial
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Catheterization
  • Catheterization, Central Venous / methods*
  • Electrocardiography*
  • Equipment Design
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / therapy*
  • Male
  • Prospective Studies
  • Umbilical Veins*