심전도를 이용한 중심 정맥 도관삽입
Central Vein Catheterization with an Electrocardiogram
이도상, 손창희, 백종민, 성기영, 김욱, 박일영, 원종만,
소속 상세정보
이도상 ( Lee Do-Sang )
가톨릭대학교 성가병원 외과학교실
손창희 ( Sohn Chang-Hee )
가톨릭대학교 성가병원 외과학교실
백종민 ( Baek Jong-Min )
가톨릭대학교 성가병원 외과학교실
성기영 ( Sung Gi-Young )
가톨릭대학교 성가병원 외과학교실
김욱 ( Kim Wook )
가톨릭대학교 성가병원 외과학교실
박일영 ( Park Il-Young )
가톨릭대학교 성가병원 외과학교실
원종만 ( Won Jong-Man )
가톨릭대학교 성가병원 외과학교실
KMID : 0371320040670030231
Abstract
PURPOSE: This study analyzed the value of an electrocardiogram (ECG) using an arterial pulsator in central vein catheterization (CVC).
METHODS: In 442 patients who underwent CVC with an ECG and an arterial pulsator, this study evaluated the rates of change in the P wave and the QRS wave at the limb lead II before and after insertion. After insertion, a plain chest X-ray was checked in order to locate the 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 was <2.0 and that of the QRS wave was <1.4. The sensitivity and the specificity of the P wave >2.0 were 95% and 100%, and those of the QRS wave >1.4 were 90% and 100%.
CONCLUSION: In central vein catheterization, an electrocardiogram with an arterial pulsator can be a useful method, and the normal position of the catheter tip can be estimated by using a rate of change in the P wave >2.0 or a rate of change in QRS wave >1.4.
키워드
중심 정맥 도관삽입; 심전도; Central vein catheterization; Electrocardiogram
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