Rosay - ECG and tip location

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Centrales venousThrombosis 20/48 42 %* 5/95 5 % 5/191 2,5 % * p < 0,0005 CVC’s Tip Loca/on: thrombosis

•  Retrospective study, 334 tunnelled catheters •  Average duration 72 days (1–720)

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Dysfunction of blood return from CVC in 200 consecutive patients

STAS - Equipe de référence des cathéters - UZLeuven

CVC’s Tip Loca/on : func/onal consequences

Tip location # %

Inominate vein/ VCI 2 1

Above 1/3 lower SVC 133 66.5

1/3 lower SVC 48 24

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Op/mal loca/on: CVC’s Tip

Atrio-cava junction (SVC-RA) 2 vertebras under the carena Way of IV line // spine

In supine position For all the devices

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Chest x-ray a_er placement?

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We are lucky!

Sinus node is on atrio-cava junc/on!

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Endocavitary ECG : Maximal P wave

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Op/mal loca/on with ECG method

During the placement: where the P wave is maximum, push it + 2 cm to correct the move in supine positition

without causing malposition

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P-wave does not increase! you are not on the right way!

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•  Yes:

– Azygos vein

•  Probably yes:

– Sinusal vein

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•  Push the catheter in the right atrium and then pull back it in the maximal P wave posi/on

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LeP vena cava

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