Evaluation of tip location reliability of intraprocedural ECG vs. Chest xrays in PICC placement

Introduction. Among the methods to assess the correct positioning of the tip of central venous catheters, the ECG method is safe and reliable. Aim. To compare the reliability of tip location by intraprocedural ECG and post-procedural radiological examination as implemented in routine care in a tertiary hospital PICC Team. Methods. 119 PICCs positioned by the Monza hospital PICC Team were examined positioned by either ECG technique or post procedural x-rays technique. The tip location was assessed in retrospect, through occasional chest ray reports. We assessed the reliability of the ECG and X rays techniques. Results. In the ECG group (75 catheters), 71 (95.7%) were correctly located vs 33/44 (75%) in the x-rays group. Conclusions. Tip location by ECG technique implemented by the PICC team is feasible and safe. The cost/benefit ratio suggests its adoption as main tip location technique.