Meta analysis of localization effect of PICC tip by intracavitary electrocardiogram

Liu Yintian; He Jinai; Song Yanling

doi:10.3969/j.issn.1009-6493.2017.36.016

Abstract：Objective:To evaluate the localization effect of intracavitary electrocardiogram(IC-ECG)on the catheter tip position of peripherally inserted central catheter.Methods:A randomized/semi randomized controlled trial was conducted by retrieving Cochrane Library、PubMed、Science Direct、EBSCO、CNKI、CBM、VIP、Wan-fang Data and using IC-ECG positioning method and RevMan5.2 software was used to deal with the final result.Results:A total of 17 articles were included,the results of Meta analysis revealed that patients had used IC-ECG positioning method and X-ray positioning method and there was no statistical difference between the two methods in confirming the accuracy of the catheter tip position[OR=1.10,95％CI(0.36,3.35),P=0.87];the disposable placement rate of catheter tip using IC-ECG positioning method was 81.3％ (n=1 294),the disposable placement rate of catheter tip using in vitro measurements was 67.6％ (n=1 105),the difference was statistically significant[OR=4.14,95％CI(2.10,8.17),P＜0.000 1];the ectopic rate of catheter tip using IC-ECG positioning method was 4.4％(n=122),the ectopic rate of catheter tip using in vitro measurements was 13.6％ (n=375),the difference was statistically significant[OR=0.24,95％CI(0.16,0.37),P＜0.000 01].Conclusion:The IC-ECG positioning method could achieve the effect of the X-ray location method in confirming the accuracy of the catheter tip and could increase the disposable placement rate of the catheter tip and reduce the ectopic rate of the catheter tip.It was recommended to use the IC-ECG positioning method in the PICC catheterization process,the emergence of characteristic P wave patients may consider exempt X-ray examination.