2009, Number 6
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Rev Med Inst Mex Seguro Soc 2009; 47 (6)
The Clinical Tests Used for Determine the Position of the Central Venous Catheter
Martínez-Flores F, Márquez-González H, Márquez-Flores H, Rodríguez-Reyes ER, Guerrero-Almeida ML
Language: Spanish
References: 14
Page: 665-668
PDF size: 29.02 Kb.
ABSTRACT
Background: chest x-ray (Rx) is the standard test
to assess correct placement of a central venous
catheter (CVC). Our objective was to validate the
use of four clinical measures (CMs) to assess the
proper placement of the line.
Methods: during a period of eight month, at the
Intensive Care Unit a prospective study was done.
A chest Rx was always obtained to assess the position
of the catheter. The CMs were: venous return;
waveform of the central venous pressure
(CVP); arrhythmias while advancing the guide wire
and the difference between planned length in cm
to be introduced and the length of the catheter introduced.
Results: for each parameter alone the sensitivity and
specificity found were: for venous return 97 % and
22 %, for CVP waveform changes 86 % and 40 %,
for arrhythmias 97 % and 60 %, for difference
between planned and real length introduced into
the patient 97 % and 50 % respectively. According
to chest x-ray, 78 % of the catheters were located
at a central position. Using the four CMs,
we obtained 86 % sensitivity and 90 % specificity
of the placement of the CVC.
Conclusions: the use of each parameter alone is
highly sensitive but poorly specific.
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