Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: A randomized open-label controlled multicenter studyReportar como inadecuado




Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: A randomized open-label controlled multicenter study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

Intracavitary electrocardiogram IC ECG guidance emerges as a new technique for peripherally inserted central catheters PICCs placement and demonstrates many potential advantages in recent observational studies.

Aims

To determine whether IC ECG-guided PICCs provide more accurate positioning of catheter tips compared to conventional anatomical landmarks in patients with cancer undergoing chemotherapy.

Methods

In this multicenter, open-label, randomized controlled study ClinicalTrials.gov number, NCT02409589, a total of 1,007 adult patients were assigned to receive either IC ECG guidance n = 500 or anatomical landmark guidance n = 507 for PICC positioning. The confirmative catheter tip positioning x-ray data were centrally interpreted by independent radiologists. All reported analyses in the overall population were performed on an intention-to-treat basis. Analyses of pre-specified subgroups and a selected large subpopulation were conducted to explore consistency and accuracy.

Results

In the IC ECG-guided group, the first-attempt success rate was 89.2% 95% confidence interval CI, 86.5% to 91.9%, which was significantly higher than 77.4% 95% CI, 73.7% to 81.0% in the anatomical landmark group P < 0.0001. This trend of superiority of IC ECG guidance was consistently noted in almost all prespecified patient subgroups and two selected large subpopulations, even when using optimal target rates for measurement. In contrast, the superiority nearly disappeared when PICCs were used via the left instead of right arms interaction P-value = 0.021. No catheter-related adverse events were reported during the PICC intra-procedures in either group.

Conclusions

Our findings indicated that the IC ECG-guided method had a more favorable positioning accuracy versus traditional anatomical landmarks for PICC placement in adult patients with cancer undergoing chemotherapy. Furthermore, there were no significant safety concerns reported for catheterization using the two techniques.



Autor: Ling Yuan , Rongmei Li , Aifeng Meng, Yuling Feng, Xiancui Wu, Yiqun Yang, Ping Chen, Zhenzhu Qiu, Jing Qi, Chuanying Chen, Jia W

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados