J Korean Soc Parenter Enter Nutr.  2007 Dec;1(1):19-22. 10.15747/jkspen.2007.1.1.19.

P Wave Change Ratio; A Technique for the Central Venous Catheterization

• Lee DS

• KMID: 1838766
• DOI: http://doi.org/10.15747/jkspen.2007.1.1.19

Abstract

PURPOSE
This study examined the value of an electrocardiogram (ECG) in central venous catheterization (CVC) for nutrition support.
METHODS
The rates of change in the P wave and the QRS wave at limb lead II before and after catheter insertion were evaluated in 442 patients who underwent CVC with an ECG. After insertion, a plain chest X-ray was checked to confirm the location of catheter tip.
RESULTS
After catheterization, the P wave and the QRS wave increased together at 97% but the P wave (change rate: 0.5~21.0) was more sensitive than the QRS wave (change rate: 0.5~5.8). For an abnormal location (3%), the rate of change in the P wave and the QRS wave was <2.0 and <1.4, respectively. The sensitivity and the specificity of the P wave >2.0 were 95% and 100%, respectively. The sensitivity and the specificity of the QRS wave >1.4 were 90% and 100%, respectively.
CONCLUSION
In central venous catheterization, ECG can be a useful method, and the normal position of the catheter tip can be estimated using the rate of change in the P wave >2.0 or the rate of change in the QRS wave >1.4.

Keyword

Central venous catheterization; Electrocardiogram

MeSH Terms

Catheterization
Catheterization, Central Venous*
Catheters
Central Venous Catheters*
Electrocardiography
Extremities
Humans
Sensitivity and Specificity
Thorax