| Title |
The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation
|
|---|---|
| Published in |
Therapeutics and Clinical Risk Management, June 2018
|
| DOI | 10.2147/tcrm.s156468 |
| Pubmed ID | |
| Authors |
Yufang Gao, Yuxiu Liu, Hui Zhang, Fang Fang, Lei Song |
| Abstract |
Tip position verification of peripherally inserted central catheters (PICCs) is essential to the use of the catheter. Postprocedural chest X-ray as the "gold standard" practice for PICC tip confirmation can lead to a significant delay for patient IV therapy, cost more, and lead to radiation exposure for both patients and staffs. Intracavitary electrocardiogram (IC-ECG)-guided PICC placement which provides real-time tip confirmation during the insertion procedure has been widely used. However, safety and accuracy of ECG for abnormal surface ECG patients, such as patients with atrial fibrillation (AF), have not been reported. To determine the safety and accuracy of IC-ECG technique for PICC tip position verification among the patients with AF. A prospective cohort study was conducted in a teaching and tertiary referral hospital with more than 3,600 beds in Qingdao, People's Republic of China. Adult patients with diagnosis of AF who need a PICC for infusion from June 2015 to May 2017 were enrolled in the study. For every included patient with AF, ECG was used to detect the PICC tip position during catheterization and X-ray was done to confirm the tip position as the "gold standard" after PICC insertion. The effectiveness and accuracy of ECG-guided catheter tip positioning and chest X-ray confirmation were compared. Totally, 118 AF patients with 118 PICCs were enrolled (58 male and 60 female, age range 50-89 years old). There was no catheterization-related complication. When the catheter entered the lower 1/3 of superior vena cava, the amplitude of f wave reached the maximum. There was no statistical difference between X-ray PICC tip position verification and IC-ECG PICC tip position verification among patients with AF (χ2=1.31, P=0.232). Utilizing the cutoff point of f wave change ≥0.5 cm, a sensitivity of 0.94, a specificity of 0.71, a positive predictive value of 0.98, and a negative predictive value of 0.42 were observed. The area under the receiver operating characteristic curve was 0.909 (95% CI: 0.810-1.000). The ECG-guided technique represents a safe and accurate technique to verify the position of PICC tip in patients with AF and could potentially remove the requirement for postprocedural chest X-ray among the patients with AF. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 17% |
| Colombia | 1 | 17% |
| Unknown | 4 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Scientists | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 41 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 17% |
| Researcher | 5 | 12% |
| Student > Bachelor | 4 | 10% |
| Student > Postgraduate | 4 | 10% |
| Professor | 3 | 7% |
| Other | 7 | 17% |
| Unknown | 11 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 17 | 41% |
| Medicine and Dentistry | 8 | 20% |
| Unspecified | 2 | 5% |
| Agricultural and Biological Sciences | 1 | 2% |
| Unknown | 13 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 September 2022.
All research outputs
#7,963,683
of 25,382,440 outputs
Outputs from Therapeutics and Clinical Risk Management
#410
of 1,323 outputs
Outputs of similar age
#128,299
of 342,877 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#14
of 33 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 1,323 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has gotten more attention than average, scoring higher than 67% of its peers.
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We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.