Anatomical Landmark Method for Paediatric Port Catheter Tip Positioning
Validation of a Palpable Anatomical Landmark Method for Tip Positioning of Paediatric Port Catheters Using Modified Intracavitary Electrocardiography: A Prospective Observational Study
This study looks at how to place port catheters safely and accurately in children who need long-term intravenous treatment.
For these treatments to work well and to avoid problems such as heart rhythm issues, blood clots, or infections, the tip of the catheter must be in the correct position inside a large vein near the heart.
Doctors commonly use two different methods to estimate the correct catheter length. One method uses body measurements and surface landmarks on the chest. The other method, called intracavitary electrocardiography (IC-ECG), uses changes in the heart's electrical signal during the procedure to guide placement.
In this study, researchers compared these two methods in children. They measured how closely the results of the two techniques matched and how much they differed.
After the catheter was placed, chest X-rays were used to check whether the catheter tip was in the correct position.
The goal of this study is to determine whether the simpler anatomical method can provide accurate and clinically reliable results compared to the IC-ECG method.
調査の概要
状態
研究の種類
入学 (実際)
連絡先と場所
研究場所
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ÇANKAYA
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Ankara、ÇANKAYA、トルコ（Türkiye）、06800
- Ankara City Hospital Bilkent
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参加基準
適格基準
就学可能な年齢
- 子
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Pediatric participants aged between 1 month and 17 years scheduled for elective port catheter placement
Exclusion Criteria:
- Participants with central venous anatomical variations or anomalies (such as persistent left superior vena cava or double superior vena cava)
- Participants with thrombosis in the target veins
- Participants with skeletal abnormalities, including anterior chest wall deformities or scoliosis
- Participants for whom parental consent could not be obtained
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Pediatric patients undergoing port catheter placement
Children undergoing port catheter placement in whom catheter length was assessed using both the anatomical landmark method and intracavitary electrocardiography (IC-ECG) within the same procedure.
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Port catheter placement procedures were performed under ultrasound guidance.
To ensure correct positioning of the catheter tip, a length estimation method based on anatomical landmarks was used.
This method was developed by reviewing contrast-enhanced chest computed tomography images of pediatric patients without thoracic deformities.
In these images, the ideal catheter tip position was identified just above the junction of the superior vena cava and the right atrium.
When this point was projected onto the chest wall, it most often corresponded to the upper border of the junction between the right third rib and the sternum.
In clinical practice, the distance between the vascular puncture site and this anatomical landmark was measured on the skin using a ruler, and the catheter length was adjusted accordingly before placement.
For each patient, two catheter length measurements were obtained: one using anatomical landmarks and one using intracavitary electrocardiography.
Although both measurements were recorded for comparison, the catheter was trimmed and placed according to the anatomical landmark method.
Intracavitary electrocardiography is a safe and cost-effective method that allows real-time confirmation of catheter tip position.
In this study, a modified approach was created using standard anesthesia monitors.
After venous access was established, the proximal end of the sterile guidewire was connected to an electrocardiogram electrode placed on the right shoulder.
As the guidewire was advanced, changes in the cardiac P-wave were monitored continuously.
The point of maximum P-wave amplitude, corresponding to the junction of the superior vena cava and the right atrium, was identified, and the corresponding intravascular length was recorded.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Agreement between anatomical landmark method and intracavitary electrocardiography for catheter length determination
時間枠：During the procedure
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Assessment of the agreement between catheter length measurements obtained using the anatomical landmark method and intracavitary electrocardiography in pediatric patients undergoing port catheter placement.
Measurements obtained by both methods were recorded in the same participants, and the difference between the two techniques was analyzed to evaluate consistency and agreement.
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During the procedure
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Radiographic accuracy of catheter tip position using the anatomical landmark method
時間枠：Within 1 day after the procedure
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Evaluation of catheter tip position after placement using the anatomical landmark method based on post-procedural chest X-ray findings.
Catheter tip location was classified as appropriate or inappropriate according to predefined radiographic criteria.
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Within 1 day after the procedure
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協力者と研究者
捜査官
- 主任研究者：Çağrı Damar, Assoc Prof、Ankara City Hospital Bilkent
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- TABED 1-25-1050
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。