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Published on: September 5, 2011
Guide wire electrode versus liquid electrode for intravascular electrocardiography-guided central venous
Guo Ling1, Wang Zhiwen2,3, Wang Guorong1
1Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Insights
This review found no significant difference in central venous catheter tip placement accuracy between guide wire and liquid electrodes. However, guide wire electrodes showed a higher risk of transient complications, necessitating further research.
Area of Science:
- Medical Devices
- Clinical Interventions
- Patient Safety
Background:
- Central venous catheter (CVC) placement is a common procedure.
- Accurate tip location is crucial for efficacy and safety.
- Intravascular electrocardiography (IEL) is used to guide CVC placement.
Purpose of the Study:
- To compare the effectiveness and safety of guide wire electrodes versus liquid electrodes for IEL-guided CVC placement in adults.
- To synthesize current evidence on the accuracy and complication rates associated with each electrode type.
Main Methods:
- Systematic review and meta-analysis of eligible studies.
- Searched multiple electronic databases from inception to March 2018.
- Included randomized controlled trials, quasi-experimental, and within-subject design studies.
Main Results:
- Six studies with 2176 participants were analyzed.
- No statistically significant difference in tip location accuracy between guide wire and liquid electrodes.
- Guide wire electrodes were associated with a higher risk of transient complications.
Conclusions:
- Current evidence is limited by the small number and low quality of studies.
- Definitive conclusions on relative effectiveness and safety cannot be drawn.
- Further well-designed studies are required to clarify the optimal electrode choice.
Aim:
To assess the effectiveness and safety of guide wire electrode versus liquid electrode for intravascular electrocardiography-guided central venous catheter placement in adults.
Design:
Systematic review and meta-analysis.
Data Sources:
We searched the main electronic databases (Cochrane Library, the Joanna Briggs Institute Library, Embase, PubMed, CINAHL, China National Knowledge Infrastructure, and Wanfang) with articles published from inception up to March 2018. References of important articles were also screened for relevant studies. We used a structured search strategy and did not apply any search limitations.
Review Methods:
Randomized, controlled trials, quasi-experimental studies or studies using a within-subject design, evaluating guide wire electrode versus liquid electrode for intravascular electrocardiography-guided central venous catheter placement in adults, were eligible for inclusion. Risk of bias assessment was performed using the Cochrane Collaboration's tool and meta-analysis was performed using RevMan 5.3.
Results:
In total, six studies with a total of 2176 participants were included. Meta-analysis showed that there was no statistically significant difference in accuracy of tip location placement between guide wire and liquid electrodes. Use of guide wire electrode had a higher risk of complications which were transient and there were an insufficient number of studies using the same parameters to evaluate intravascular electrocardiography signal quality.
Conclusion:
Due to the small number and low quality of identified studies, it is difficult to draw definitive conclusions on the relative effectiveness and safety of guide wire versus liquid electrodes for the placement of central venous catheters in adults. More well-designed studies are needed in the future.
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