Use of electrocardiography for accurate placement of central venous catheters in Austria

After placement of a central venous catheter the correct position of the ca theter tip has to be verified. The use of intravascular ECG tracing via a g uide-wire or via the saline-filled lumen of the catheter enables immediate and safe control of the position. Only if complications (e. g. pneumothorax ) are suspected, further clinical and radiological diagnostics are necessar y. Up to now, no data on the routine clinical use of this method are availa ble. In April 1998, a semi-structured questionnaire was sent to the 518 heads of anaesthesiological, surgical and medical departments in Austria (33 % of t he questionnaires were returned). The subclavian (56 %) and internal jugula r veins (35 %) are most frequently used for catheter insertion in Austria. Verification of the catheter tip placement by EGG-guidance is used in only 8 % of cases, while radiographs are performed in most cases. Uncertainty wi th respect to forensic consequences of using the EGG-guidance for control o f the catheter tip placement and the possible necessity of an additional ra diograph are the main problems seen by the heads of the departments. After placement of a central venous line, measures for the verification of the catheter tip and measures for the control of possible complications hav e to be considered separately. Intravascular ECG tracing is unable to detec t complications. Concerning the verification of the catheter tip position m any studies confirm the easy handling, relevance of results and cost saving s for this method. Its use for the control and documentation of the tip loc ation is considered a standard. In Austria the consequent use of the method would offer the chance for significant reductions of treatment costs.