Clinical Tests to Determine the Correct Position of Central Venous Catheter in Overweight Patients in Critically Ill Condition
Álvaro José Montiel-Jarquín *
Division of Health Research, Medical Unit, High Specialty Hospital of Traumatology and Orthopedics, Mexican Social Security Institute, Puebla, Mexico and Department of Postgraduate, National Academy of Medical Education, Popular Autonomous University of Puebla, Mexico
Rodolfo Gregorio Barragán-Hervella
Division of Health Research, Medical Unit, High Specialty Hospital of Traumatology and Orthopedics, Mexican Social Security Institute, Puebla, Mexico and Department of Postgraduate, National Academy of Medical Education, Popular Autonomous University of Puebla, Mexico
Jorge Loría-Castellanos
Division of Special Projects in Health, Mexican Social Security Institute, National Academy of Surgery, Puebla, Mexico
Eugenio García-Cano
Division of Health Research, Medical Unit, High Specialty Hospital of Traumatology and Orthopedics, Mexican Social Security Institute, Puebla, Mexico and Department of Postgraduate, National Academy of Medical Education, Popular Autonomous University of Puebla, Mexico and Department of Posgraduate, Popular Autonomous University of Puebla, Mexico
Hugo Alejandro Solis-Mendoza
Department of Posgraduate, Popular Autonomous University of Puebla, Mexico
María del Socorro Romero-Figueroa
Health Research Coordination at Toluca Delegation, Mexican Social Security Institute, Mexico
Ivet Etchegaray-Morales
Faculty of Medicine, Meritorious Autonomous University of Puebla, Mexico
Mario Gerardo Herrera-Velasco
Division of Health Research, Medical Unit, High Specialty Hospital of Traumatology and Orthopedics, Mexican Social Security Institute, Puebla, Mexico and Department of Postgraduate, National Academy of Medical Education, Popular Autonomous University of Puebla, Mexico
Carlos Sánchez-Gazca
Division of Health Research, Medical Unit, High Specialty Hospital of Traumatology and Orthopedics, Mexican Social Security Institute, Puebla, Mexico and Department of Postgraduate, National Academy of Medical Education, Popular Autonomous University of Puebla, Mexico
Miguel Cruz-Vázquez
Department of Posgraduate, Popular Autonomous University of Puebla, Mexico
*Author to whom correspondence should be addressed.
Abstract
Objective: To demonstrate the utility of clinical test to determine the correct placement of the CVC in overweight patients in critical condition.
Methods: Cross-sectional Study carried out in the Intensive Care Unit of the High Speciality Medical Unit of Traumatology and Orthopedics from Mexican Social Security Institute during 2014. The variables were age, sex, Body Mass Index and clinical diagnostic test. The placement of the catheter was done percutaneously, once the catheter was placed, clinical tests for determining the correct placement were done, verifying cardiac arrhythmias, test of venous return, measurement of Central Venous Catheter pressure and external length of the catheter. The statistics used was descriptive.
Results: Thirty-one patients were included. To all the patients clinical diagnosis tests were performed to verify the correct placement of the Central Venous Catheter (58%). The average Body Mass Index was 26. Of the catheters placed, 29.03% were central and 70.96% were misplaced, according to the chest x-ray. The arrhythmias were presented in 9.67%, with a specificity of 90%, and negative predictive value of 90%. The variations in central venous pressure were presented in 32.25% patients; the sensitivity was 20%, the specificity and negative predictive value were 60% respectively.
Conclusion: We found low sensitivity and good specificity for these clinical tests.
Keywords: Clinical tests, critical care, Central Venous Catheter.