A prospective randomized clinical assessment of a new pigtail central venous catheter in comparison with standard alternatives

Abstract

The Cook Pigtail central venous catheter (CVC) has been designed to diminish the risk of vascular perforation and consequent cardiac tamponade. With the participation of 12 consultant anaesthetists and 19 registrars, adults undergoing elective surgery were randomized to receive either a Pigtail (n = 101) or their consultant anaesthetists' "standard" CVC (n = 102). Median ease of insertion was rated 8 for Pigtail CVCs and 9 for standards (10 being best; P = 0.001). Arrhythmias occurred during 16 standard and 33 Pigtail central venous catheter insertions (P < 0.006). No significant difference was found in insertion time or radiographically assessed tip depth for standard and Pigtail central venous catheters. A perforated right atrium of uncertain cause occurred in a patient who received an Arrow triple-lumen central venous catheter. Participating consultant anaesthetists preferred their "standard" central venous catheter for routine use, but five indicated that they would select a Cook Pigtail where long-term use was planned because of in vitro evidence of its greater safety.