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Evaluation of the Sherlock 3CG Tip Confirmation System on peripherally inserted central catheter malposition rates
Author(s) -
Johnston A. J.,
Holder A.,
Bishop S. M.,
See T. C.,
Streater C. T.
Publication year - 2014
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12785
Subject(s) - medicine , superior vena cava , catheter , atrium (architecture) , peripherally inserted central catheter , vena cava , surgery , inferior vena cava , right atrium , chest radiograph , critically ill , central venous catheter , atrial fibrillation , radiography , cardiology
Summary Peripherally inserted central catheters are often positioned blindly in the central circulation, and this may result in high malposition rates, especially in critically ill patients. Recently, a new technology has been introduced (Sherlock 3CG Tip Positioning System) that uses an electro‐magnetic system to guide positioning in the superior vena cava, and then intra‐cavity ECG to guide positioning at the cavo‐atrial junction. In this observational study, we investigated how the Sherlock 3CG Tip Positioning System would affect peripherally inserted central catheter malposition rates, defined using a post‐insertion chest radiograph, in critically ill patients. A total of 239 catheters positioned using the Sherlock 3CG Tip Positioning System were analysed. When an adequate position was defined as low superior vena cava or cavo‐atrial junction, 134 catheters (56.1%; 95% CI 50–62%) were malpositioned. When an adequate position was defined as mid/low superior vena cava, cavo‐atrial junction or high right atrium (≤ 2 cm from cavo‐atrial junction), 49 (20.5%; 95% CI 16–26%) catheters were malpositioned. These malposition rates are significantly lower than our own historical data, which used a ‘blind’ anthropometric technique to guide peripherally inserted central catheter insertion.