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Randomized comparison of three guidewire insertion depths on incidence of arrhythmia during central venous catheterization

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Author(s)
Jung-Man LeeJiwon LeeJin-Young HwangJee-Eun ChangHeyrimKimaSohee OhEun-Ah OhSeong-Won Min
Keimyung Author(s)
Lee, Ji Won
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
American Journal of Emergency Medicine
Issued Date
2017
Volume
35
Issue
5
Keyword
ArrhythmiaCentral catheterizationGuidewire
Abstract
Objective :
Guidewire-induced arrhythmias that occur during central venous catheterization can progress to malignant arrhythmias in rare cases. This study compared the incidence of arrhythmia during central venous catheterization using three different depths of guidewire insertion into the right internal jugular vein.
Methods : Sixty-nine patients undergoing elective surgery requiring central venous catheterization through the right internal jugular vein were enrolled in this double-blind, prospective, randomized, and controlled study. Patients were randomly allocated to receive guidewire insertions to 15 cm, 17.5 cm, or 20 cm before tissue dilation. Arrhythmic episodes were then monitored during dilation of the soft tissue.
Results : A total of 29 patients (42%) experienced arrhythmic episodes during tissue dilation. The guidewire-induced arrhythmia rates of the 15 cm group, 17.5 cm group, and 20 cm group were 0.26 (95% confidence interval [CI] = 0.10, 0.48), 0.35 (95% CI = 0.16, 0.57), and 0.65 (95% CI = 0.43, 0.84), respectively. The incidence of arrhythmic episodes was higher in the 20 cm group than in the 15 cm (odds ratio [OR] = 5.31; 95% CI = 1.50, 18.84) and 17.5 cm (OR =3.52; 95% CI = 1.05, 11.83) groups. There was no significant difference in arrhythmia rates between the 15 cm group and 17.5 cm group (p = 0.542).
Conclusions : During central venous catheterization through the right internal jugular vein, inserting guidewires to depths of 15 or 17.5 cm before tissue dilation reduced the incidence of arrhythmic episodes compared to a depth of 20 cm.
Keimyung Author(s)(Kor)
이지원
Publisher
School of Medicine
Citation
Jung-Man Lee et al. (2017). Randomized comparison of three guidewire insertion depths on incidence of arrhythmia during central venous catheterization. American Journal of Emergency Medicine, 35(5), 743–748. doi: 10.1016/j.ajem.2017.01.016
Type
Article
ISSN
0735-6757
Source
https://linkinghub.elsevier.com/retrieve/pii/S0735675717300165
DOI
10.1016/j.ajem.2017.01.016
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32718
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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