Abstract
Objective: Assess the location effect of the atrial electrogram in the PICC catheter tip. Method: Make online research in the CNKI, CBM, Wanfang, VIP, Database, Cochrane Library, JBI Library, PubMed, Ovid, Springer, Web of science, MEDLINE database to collect the randomized controlled trial data of using the atrial electrogram to locate the PICC catheter tip. When making the online research, only the data to November 20, 2016 can be searched out. Two researchers independently select the literature and information, make quality assessment, and then use the RevMan 5.2 software to make Meta analysis. Result: 16 random tests are done. The Meta analysis results show that compared with the traditional X ray chest radiograph location method, the atrial electrogram can increase the accuracy rate of the location of the catheter tip [RR = 1.13, 95%CI (1.07, 1.19), P −12.56, 95%CI (−18.56, −6.57), P < 0.0001]. Conclusion: The atrial electrogram can increase the accuracy rate of the location of the catheter tip, decrease the incidence rate of related complications and save the catheter placing time. Therefore, it is worthy of clinical application.
Highlights
Inserted central catheter (PICC) has been widely applied in our country due to its advantages, namely, long-term use, reduced puncture pain, safety, efficiency, resistance to hypertonic and intense irritant drugs as well as fewer complications [1]
The accuracy of applying atrial electro-gram technique to Peripherally inserted central catheter (PICC) catheter tip location was analyzed in 16 randomized controlled studies, and the total sample size was 2996, statistical heterogeneity exists among various studies (RR = 1.13, I2 = 79%, P < 0.00001), so the random effect model was used for meta-analysis (P < 0.05)
The Meta-analysis showed that the accuracy of the PICC catheter at the lower 1/3 of the superior vena cava in the atrial electro-gram positioning group was higher than that in the X-ray chest positioning group. [RR = 1.13, 95% CI (1.07, 1.19), P < 0.00001]
Summary
Inserted central catheter (PICC) has been widely applied in our country due to its advantages, namely, long-term use, reduced puncture pain, safety, efficiency, resistance to hypertonic and intense irritant drugs as well as fewer complications [1]. With the progress of the discipline, X-ray positioning method, as the “gold standard” of PICC tip location shows its hysteretic nature [3], and it is gradually replaced by atrial electro-gram due to its drawback of radiation damage for pregnant women, children and other special groups. There are many studies regarding the application of atrial electro-gram on PICC catheter tip location, but the majority of them are lack of evidences and clinical practice guidelines to confirm the accuracy and superiority [4] [5]. The aim of this study is to investigate the accuracy and advantages of atrial electro-gram in the location of the tip of PICC catheters, with a view to providing references for clinical care and the clinical practice guidelines of selecting a tip location method after PICC catheterization
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call