Christiane Theda, MD PhD MBA: Multiple Australian Grant Agencies: Grant/Research Support (Ongoing); Navi Medical Technologies Pty Ltd: Employed, Co-Founder, Share Holder, Director (Ongoing); Royal Children's Hospital Melbourne: Employed as Physician (Ongoing); Royal Women's Hospital Melbourne: Employment as Physician (Ongoing)
Central vascular access is essential for efficient and safe care of babies in the NICU setting. While access in sick term infants can be difficult, extremely preterm babies present additional significant challenges due to their small size and the need to use the smallest of catheters; small movement of catheter tips can result in significant malposition and risk of complications is high. Compared to older patient populations, intravascular ECG (IV-ECG) is used much less in NICU. To utilise IV-ECG for access via the umbilical vessels or lower extremity peripheral veins, IV-ECG patterns indicating proper catheter position need to be defined and verified. We have performed hundreds of recordings in a single center and present not only summative data but also very practical examples and interesting cases relating to IV-ECG use in NICU. We illustrate the challenges and opportunities of day-to-day use of IV-ECG as a NICU bedside technique providing real time feedback on catheter tip position.
Learning Objectives:
describe how intravascular ECG tip location can aid placement and monitoring of central lines placed through upper extremity, lower extremity or umbilical vessels
understand the opportunities intravascular ECG has to offer as a clinical tool in the NICU setting; explore the interplay between tip location as assessed by intravascular ECG and imaging utilizing radiographic and ultrasound techniques.
describe and understand the opportunities intravascular ECG has to offer as a clinical tool in the NICU setting including detection of catheter migration
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