Peripherally Inserted Central Catheter Thrombosis After Placement via Electrocardiography vs Traditional Methods

Background Peripherally inserted central catheter tip placement at the cavoatrial junction is associated with reduced catheter-related deep vein thrombosis. Electrocardiographic confirmation purportedly improves accuracy of placement, but whether this approach can reduce thrombosis unknown. Methods Prospectively collected data from patients that received peripherally catheters 52 Michigan hospitals were analyzed. The method used to confirm insertion and outcomes extracted medical records. Multivariate models (accounting for clustered nature data) fitted assess association between (electrocardiographic vs radiographic imaging). Results A total 42,687 (21,098 radiology 21,589 electrocardiographic) included. Patients receiving electrocardiographic-confirmed had fewer comorbidities compared those underwent via radiology. Overall, occurred in 594 (1.3%) all catheters. Larger size (odds radio [OR] 1.32; 95% confidence interval [CI], 0.93-1.90 per unit increase gauge), history thrombosis, cancer increased risk (OR 2.00; CI, 1.65-2.43 OR 1.62; 1.16-2.26, respectively) using logistic regression. Following adjustment, electrocardiographic guidance was a significant reduction imaging 0.74; 0.58-0.93; P = .0098). Conclusion use electrocardiography significantly events than imaging. Use may help improve patient safety, particularly high-risk patients.