Related Experiment Video
Updated: Feb 26, 2026
The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
An Accuracy Study of the Intracavitary Electrocardiogram (IC-ECG) Guided Peripherally Inserted Central Catheter Tip
Lian-Juan Zhou1, Hong-Zhen Xua1, Mei-Fang Xu1
1Department of Nursing, Children's Hospital, Zhejiang University School of Medicine, No.3333 Bing-sheng Road, Hangzhou, 310051, P.R.China.
Objective:
To explore the clinical application of the intracavitary electrocardiogram (IC-ECG) guided Peripherally Inserted Central Catheter (PICC) tip placement among neonates.
Background:
the ECGs of neonates are difficult to perform and their wave shapes are of doubtful accuracy due to various interfering factors.
Method:
115 neonates were admitted to perform PICC guided by IC-ECG. Logistic regression was performed to analyze all possible influencing factors of the accuracy from the tip placement. The puncture site of the PICC, gestational age, height, weight, basal P/R amplitude and positioning P/R amplitude might be related to the accuracy of IC-ECG location.
Result:
The accuracy in the lower extremity was higher than that in the upper extremity. Multivariate logistic regression analysis showed that the weight (Odds Ratio (OR)=1.93, 95%Confidence Interval(CI):1.06-3.50) and positioning P/R amplitude (OR=32.33, 95%CI: 2.02-517.41) are statistically significant risks to the accuracy PICC tip placement.
Conclusions:
Possible methods to improve the accuracy might be Catheterizing through lower extremity, keeping the neonates calm, enhancing the electrocardiogram signal and strengthening technical training. Therefore it is practical to perfrom a tip placement by the dynamic change in the P waves from an electrocardiogram (ECG) guided PICC among neonates and as reliable as using X-rays.
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...