Central Venous Catheter Placement With Thoracic Ultrasound and Intracavity ECG Positioning
A Randomised Feasibility Study of Real-time Intracavity ECG and Thoracic Ultrasound for Central Venous Catheter Tip Confirmation in Critical Care
York Teaching Hospitals NHS Foundation Trust
75 participants
May 15, 2026
INTERVENTIONAL
Conditions
Summary
The goal of this interventional study is to assess the feasibility of two bedside techniques for confirming central venous catheter (CVC) placement and detecting complications: * Intracavity ECG monitoring to confirm internal jugular vein CVC tip position. * Thoracic point-of-care ultrasound (POCUS) to rule out pneumothorax following CVC insertion. Participants who require an internal jugular CVC as part of their routine care and meet all inclusion and no exclusion criteria will be randomised to receive either: * Standard care, or * The intervention, consisting of intracavity ECG guidance and thoracic POCUS. The CVC will be inserted either on the left or right side of the neck. All participants will undergo a post-procedure chest X-ray regardless of study arm, to allow comparison of the intervention methods with standard care.
Eligibility
Inclusion Criteria4
- Adult (aged ≥ 18 years)
- Admitted, or planned for admission, to critical care
- Requiring central venous catheter insertion as a part of their usual care
- Suitable for both right or left internal jugular vein insertion
Exclusion Criteria14
- Previously randomised into CVC-TIP
- Atrial fibrillation on 12-lead ECG
- Cardiovascular instability, defined as
- Noradrenaline dose > 0.5mcg/kg/min
- Rapidly escalating doses of vasopressors / inotropes
- Difficulty in obtaining thoracic ultrasound images due to either
- Weight > 120kg
- Existing pneumothorax (either side)
- Subcutaneous emphysema
- Wounds / dressing over anterior chest wall
- Existing pacemaker
- Non-English speaking participants
- Death perceived as imminent
- Any other reason as determined by treating clinician
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Interventions
Vygon PILOT TLS (Tip Location System) used to provide intracavity ECG monitoring for central venous catheter tip positioning.
Thoracic point of care ultrasound used to scan both lung fields to rule out pneumothorax
Locations(1)
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NCT07291869