Comparison of Two ECG Guided PICC Insertion Techniques

NCT ID: NCT04466332

Last Updated: 2022-09-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

320 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2021-08-20

Brief Summary

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The aim of our study is to compare two ECG techniques for guiding Peripherally Inserted Central Venous Cather (PICC) in terms of accuracy of the final position of the catheter tip.

Detailed Description

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One technique uses ECG signal transmission with saline water and allows external catheter length adjustment while the other technique uses a guidewire for signal transmission thus requiring prior catheter length adjustment

Conditions

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Central Venous Access Long Term Antibiotics Chemotherapy Total Parenteral Nutrition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Saline ECG with Pilot Tip Location System

PICC insertion using electrocardiographic guidance Pilot Tip Location System (TLS), ECG signal transmission is with saline water

Group Type EXPERIMENTAL

LifeCath-CT PICC easy™ (Vygon)

Intervention Type DEVICE

ECG electrodes are placed on patient's chest ensuring that there is a distinguishable P-wave.

Upper arm selection is based on vein diameter and dominance, ultrasound is used to identify a suitable vein.

The patient is prepared using a maximal sterile barrier approach. The catheter is inserted into one of the veins (75-90° arm abduction) using ultrasound and modified Seldinger technique.

The PICC is advanced into the central circulation and used as an intracavitary electrode (connection with Vygocard2™). Saline water instilled through the catheter ensures conductivity.

The ECG is then used until displayed intracavitary P-wave has a maximal height without negative deflexion. Catheter is left at this point (cavo atrial junction).

The PICC hub side is then trimmed and the catheter part connected. The PICC is caped with a neutral bidirectional valve.

The puncture site is dressed and catheter stabilized. Chest Xray is obtained immediately after insertion to assess the position.

Guidewire ECG with Sherlock Tip Confirmation System

PICC insertion using electrocardiographic guidance Sherlock 3CG Tip Confirmation System (TCS), ECG signal transmission is with guidewire

Group Type EXPERIMENTAL

PowerPICC-SOLO® (C.R. Bard)

Intervention Type DEVICE

ECG electrodes are placed on patients chest ensuring that there is a distinguishable P-wave.

Upper arm selection is based on vein diameter and dominance, ultrasound is used to identify suitable vein.

The patient is prepared using a maximal sterile barrier approach. The catheter is inserted into one of the veins (75-90° arm abduction) using ultrasound and modified Seldinger technique.

The catheter's free end is cut to the anticipated length using anthropometric measurements (insertion/axillary crease+axillary crease/sternal notch+13cm) and the preloaded magnetic-tipped stylet (serving as intracavitary electrode) is put inside.

The PICC is advanced into central veins until intravascular ECG displays a P-wave with maximal height without negative deflexion. Catheter is left at this point (cavo atrial junction).

The puncture site is dressed and catheter stabilized. Chest Xray is obtained immediately after insertion to assess position.

Interventions

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LifeCath-CT PICC easy™ (Vygon)

ECG electrodes are placed on patient's chest ensuring that there is a distinguishable P-wave.

Upper arm selection is based on vein diameter and dominance, ultrasound is used to identify a suitable vein.

The patient is prepared using a maximal sterile barrier approach. The catheter is inserted into one of the veins (75-90° arm abduction) using ultrasound and modified Seldinger technique.

The PICC is advanced into the central circulation and used as an intracavitary electrode (connection with Vygocard2™). Saline water instilled through the catheter ensures conductivity.

The ECG is then used until displayed intracavitary P-wave has a maximal height without negative deflexion. Catheter is left at this point (cavo atrial junction).

The PICC hub side is then trimmed and the catheter part connected. The PICC is caped with a neutral bidirectional valve.

The puncture site is dressed and catheter stabilized. Chest Xray is obtained immediately after insertion to assess the position.

Intervention Type DEVICE

PowerPICC-SOLO® (C.R. Bard)

ECG electrodes are placed on patients chest ensuring that there is a distinguishable P-wave.

Upper arm selection is based on vein diameter and dominance, ultrasound is used to identify suitable vein.

The patient is prepared using a maximal sterile barrier approach. The catheter is inserted into one of the veins (75-90° arm abduction) using ultrasound and modified Seldinger technique.

The catheter's free end is cut to the anticipated length using anthropometric measurements (insertion/axillary crease+axillary crease/sternal notch+13cm) and the preloaded magnetic-tipped stylet (serving as intracavitary electrode) is put inside.

The PICC is advanced into central veins until intravascular ECG displays a P-wave with maximal height without negative deflexion. Catheter is left at this point (cavo atrial junction).

The puncture site is dressed and catheter stabilized. Chest Xray is obtained immediately after insertion to assess position.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Informed Consent as documented by signature (Appendix Informed Consent Form)
* Adult \> 18 years
* Referred to the interventional radiology department for PICC insertion

Exclusion Criteria

* Known or suspected non-compliance
* Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant
* Previous enrolment into the current study
* Enrolment of the investigator, his/her family members, employees and other dependent persons
* Impairment of the heart rhythm changing the presentation of the P wave (atrial fibrillation, atrial flutter, severe tachycardia, pacemaker driven rhythm)
* Enrolled in conflicting research study
* Weight\> 150 kg, technical limit for the fluoroscopy table
* Impossibility of obtaining informed consent
* Refusal to be informed in the event of a chance discovery
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Universitaire Vaudois

OTHER

Sponsor Role collaborator

University of Lausanne

OTHER

Sponsor Role lead

Responsible Party

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Salah D. Qanadli, MD, PhD

Professor MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Salah Dine Qanadli, Prof. MD PhD

Role: STUDY_DIRECTOR

UNIL-CHUV

Locations

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CHUV

Lausanne, Canton of Vaud, Switzerland

Site Status

Countries

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Switzerland

Other Identifiers

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2020-00583

Identifier Type: -

Identifier Source: org_study_id

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