A Randomised Feasibility Study of Real-time Intracavity ECG and Thoracic Ultrasound for Central Venous Catheter Tip Confirmation in Critical Care

What this Trial Is About

This research aims to evaluate the feasibility of two bedside methods to confirm the placement of central venous catheters CVCs and detect complications in critically ill patients. It compares intracavity electrocardiography IC-ECG, which monitors heart electrical activity to guide catheter tip position, and thoracic point-of-care ultrasound POCUS, which checks for pneumothorax after CVC insertion. The study is a single-center, prospective, randomized feasibility trial to improve speed and safety in CVC verification compared to standard chest X-ray. Participants needing an internal jugular vein CVC will be randomly assigned to one of three groups CVC insertion on the left side with IC-ECG and thoracic POCUS, CVC insertion on the right side with these techniques, or standard care involving ultrasound-guided insertion with post-procedure chest X-ray only. All participants will receive a chest X-ray after the procedure to compare the new methods with standard care. Throughout the 12-month recruitment period, researchers will measure recruitment rates, protocol adherence, data completeness, technical success, and time taken to confirm catheter tip position. They will also monitor complications up to 48 hours after insertion, review ultrasound and ECG images for consistency, assess operator confidence, and evaluate how often chest X-rays might be avoided. The study will help design larger future trials to assess accuracy and cost-effectiveness of these techniques in critical care.

Central Venous Catheter Placement With Thoracic Ultrasound and Intracavity ECG Positioning