A prospective randomized clinical assessment of a new pigtail central venous catheter in comparison with standard alternatives

The Cook Pigtail central venous catheter (CVC) has been designed to diminis h the risk of vascular perforation and consequent cardiac tamponade. With t he participation of 12 consultant anaesthetists and 19 registrars, adults u ndergoing elective surgery were randomized to receive either a Pigtail (n = 101) or their consultant anaesthetists' "standard" CVC (n = 102). Median e ase of insertion was rated 8 for Pigtail CVCs and 9 for standards (10 being best; P = 0.001). Arrhythmias occurred during 16 standard and 33 Pigtail c entral venous catheter insertions (P < 0.006). No significant difference wa s found in insertion time or radiographically assessed tip depth for standa rd and Pigtail central venous catheters. A perforated light atrium of uncer tain cause occurred in a patient who received an Arrow triple-lumen central venous catheter Participating consultant anaesthetists preferred their "st andard" central venous catheter for routine use, but five indicated that th ey would select a Cook Pigtail where long-term use was planned because of i n vitro evidence of its greater safety.