Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy

2018 ◽  
Vol 19 (6) ◽  
pp. 609-614 ◽  
Author(s):  
Soshi Nakamuta ◽  
Toshihiro Nishizawa ◽  
Shiori Matsuhashi ◽  
Arata Shimizu ◽  
Toshio Uraoka ◽  
...  
Keyword(s):  
Success Rate ◽  
Detection Rate ◽  
Ultrasound Guidance ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Ultrasound Guided ◽  
Peripherally Inserted Central Catheters ◽  
X Ray ◽  
Central Catheters

Background and aim: Malposition of peripherally inserted central catheters placed at the bedside is a well-recognized phenomenon. We report the success rate of the placement of peripherally inserted central catheters with ultrasound guidance for tip positioning and describe the knacks and pitfalls. Materials and methods: We retrospectively reviewed the medical case charts of 954 patients who received peripherally inserted central catheter procedure. Patient clinical data included success rate of puncture, detection rate of tip malposition with ultrasonography, adjustment rate after X-ray, and success rate of peripherally inserted central catheter placement. Results: The success rate of puncture was 100% (954/954). Detection rate of tip malposition with ultrasonography was 82.1% (78/95). The success rate of ultrasound-guided tip navigation was 98.2% (937/954). The success rate of ultrasound-guided tip location was 98.0% (935/954). Adjustment rate after X-ray was 1.79% (17/952). The final success rate of peripherally inserted central catheter placement was 99.8% (952/954). Conclusion: Ultrasound guidance for puncturing and tip positioning is a promising option for the placement of peripherally inserted central catheters. Ultrasound guidance could dispense with radiation exposure and the transfer of patients to the X-ray department.

Peripherally inserted central catheter placement in a multidisciplinary intensive care unit: A preliminary study demonstrating safety and procedural time in critically ill subjects

2020 ◽  
pp. 112972982092861
Author(s):  
Ryan J Smith ◽  
Rodrigo Cartin-Ceba ◽  
Julie A Colquist ◽  
Amy M Muir ◽  
Jeanine M Moorhead ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Patients ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Time Required ◽  
Central Catheters

Objective: Peripherally inserted central catheters are a popular means of obtaining central venous access in critically ill patients. However, there is limited data regarding the rapidity of the peripherally inserted central catheter procedure in the presence of acute illness or obesity, both of which may impede central venous catheter placement. We aimed to determine the feasibility, safety, and duration of peripherally inserted central catheter placement in critically ill patients, including obese patients and patients in shock. Methods: This retrospective cohort study was performed using data on 55 peripherally inserted central catheters placed in a 30-bed multidisciplinary intensive care unit in Mayo Clinic Hospital, Phoenix, Arizona. Information on the time required to complete each step of the peripherally inserted central catheter procedure, associated complications, and patient characteristics was obtained from a prospectively assembled internal quality assurance database created through random convenience sampling. Results: The Median Procedure Time, beginning with the first needle puncture and ending when the procedure is complete, was 14 (interquartile range: 9–20) min. Neither critical illness nor obesity resulted in a statistically significant increase in the time required to complete the peripherally inserted central catheter procedure. Three (5.5%) minor complications were observed. Conclusion: Critical illness and obesity do not delay the acquisition of vascular access when placing a peripherally inserted central catheter. Concerns of delayed vascular access in critically ill patients should not deter a physician from selecting a peripherally inserted central catheter to provide vascular access when it would otherwise be appropriate.

scholarly journals Experience of Radiology Technologists Performing Peripherally Inserted Central Catheters (PICC)

2021 ◽  
Author(s):  
I. Aljediea ◽  
M. Alshehri ◽  
K. Alenazi ◽  
A. Memesh ◽  
M. Fleet
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Ultrasound Guidance ◽  
Review Process ◽  
Peripherally Inserted Central Catheters ◽  
X Ray ◽  
Venous Puncture ◽  
Local Experience ◽  
Chest X Ray ◽  
Central Catheters

Abstract Purpose We conducted this study to review our local experience of performing peripherally inserted central catheters by interventional radiology technologists. Materials and Methods This is a retrospective study of peripherally inserted central catheters performed by interventional radiology technologists. These procedures were performed using ultrasound guidance for venous puncture and fluoroscopy or electrocardiography guidance followed by chest X-ray to confirm tip location. Results We reviewed all peripherally inserted central catheters performed in interventional radiology between May 2017 and July 2020. The review process included the success rate, number of venous puncture attempts, method of guidance, procedure time, fluoroscopy time, catheter duration to removal, and complications. Conclusion Interventional radiology technologists can perform peripherally inserted central catheters safely with high success rate. Extending interventional radiology technologists' role to perform peripherally inserted central catheters allow interventional radiologists to do more complex procedures. This enhances the workflow, increases the interventional radiology team efficiency, and improves the waiting time.

Percutaneous removal of a precariously placed pericardial peripherally inserted central catheter

2019 ◽  
Vol 20 (6) ◽  
pp. 778-781
Author(s):  
Trevor Tyner ◽  
Noelle McNaught ◽  
Matthew B. Shall ◽  
Mark L. Lessne
Keyword(s):  
Parenteral Nutrition ◽  
Unusual Complication ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Blood Products ◽  
Peripherally Inserted Central Catheters ◽  
Percutaneous Removal ◽  
Essential Function ◽  
Central Catheters

Peripherally inserted central catheters provide access to the central chest veins and allow administration of long-term antibiotics, chemotherapy, blood products, fluids, and parenteral nutrition. Peripherally inserted central catheters provide an essential function and are routinely placed safely, but are not without risks. This case describes an unusual complication of peripherally inserted central catheter perforation into the pericardial space with subsequent successful percutaneous removal.

Prone positioning for peripherally inserted central catheter on a patient with anal cancer

2019 ◽  
Vol 21 (1) ◽  
pp. 103-104
Author(s):  
Ferdinando Longo ◽  
Fabio Costa ◽  
Chiara Piliego ◽  
Felice E Agrò
Keyword(s):  
Prone Position ◽  
Anal Cancer ◽  
Peripherally Inserted Central Catheter ◽  
Prone Positioning ◽  
Central Catheter ◽  
Difficult Patient ◽  
Peripherally Inserted Central Catheters ◽  
Central Access ◽  
Central Catheters ◽  
Usual Position

Peripherally inserted central catheters are usually inserted in supine patients. What should we do when facing a patient who cannot tolerate this position? In this article, we are describing a particularly difficult patient: not only supine decubitus was intolerable to her but lying on the side was unbearable, too. That is why, to manage a patient who required a central access but could not tolerate the usual position for placing it, we tried to do that in prone position.

scholarly journals Peripherally inserted central catheter in newborns: association of number of punctures, vein, and tip positioning

2021 ◽  
Vol 55 ◽  
Author(s):  
Thaís Aquino Carneiro ◽  
Keline Soraya Santana Nobre ◽  
Fernanda Cavalcante Fontenele ◽  
Ana Paula Melo Façanha ◽  
Roberta Pinheiro Ferreira
Keyword(s):  
Incomplete Data ◽  
Maternity Hospital ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Peripherally Inserted Central Catheters ◽  
Catheter Tip ◽  
Convenience Sampling ◽  
Tip Position ◽  
Central Catheters ◽  
Indications For Use

ABSTRACT Objective: to assess the use of peripherally inserted central catheters regarding the neonate’s profile, indications for use, and catheterized vein; the relation between the number of puncture attempts and vein; and assessment of the catheter tip position. Method: documentary, descriptive, retrospective, quantitative study, developed in a tertiary maternity hospital in Ceará. A total of 3,005 PICC insertion formularies was included and 1,583 were excluded due to incomplete data, with a convenience sampling of 1,422 insertions being obtained. Results: There were 1,200 (84.4%) newborns with gestational age below 37 weeks; 781 (54.9%) males; Apgar score above 7 in the first (628–44.2%) and fifth minutes (1,085–76.3%); and weight between 1,000 and 1,499 grams on the day of insertion (417–29.3%). Antibiotic therapy had 1,155–53.8% indications for insertion; the basilic was the most used vein (485–34.1%); basilic and cephalic veins had lower median puncture attempts and 1,124–79% insertions were centrally positioned. Conclusion: The results of this research highlight the continuous need to improve technical-scientific knowledge to qualify actions in neonatology.

Letters

2008 ◽  
Vol 27 (6) ◽  
pp. 427-427
Author(s):  
Lee Shirland
Keyword(s):  
Vascular Access ◽  
Great Risk ◽  
Skin Closure ◽  
System State ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Peripherally Inserted Central Catheters ◽  
Vascular Access Devices ◽  
Dressing Change ◽  
Central Catheters

I am writing concerning an article titled “Neonatal Peripherally Inserted Central Catheters: Recommendations for Prevention of Insertion and Postinsertion Complications,” published in Vol. 27, No. 4 (July/August 2008), pages 245– 257. Of concern are Figures 3 and 4 on page 253 titled securing the catheter with adhesive skin closure strips and looping the catheter. The instructions and pictures demonstrate how to secure the catheter using skin closure strips and show the strips placed over the catheter. This is of great concern. The manufacturer’s recommendations on BD L-Cath System state the following on page 8 line 26, “Secure the catheter and dress the site with a sterile dressing. Tapes and securing devices should never be applied directly to the non-protected catheter.” This caution is echoed in the article titled “Tiny Patients, Tiny Dressings: A Guide to Neonatal PICC Dressing Change,” published in Advances in Neonatal Care, Vol. 8, No. 3, pages 141–162. The author states the following, “Some hospitals use skin closure strips. If these are utilized, manufacturer’s recommendations should be followed, and they should never be placed directly overlying the catheter to avoid catheter breakage and embolism.” The author supports this statement with the following reference, Frey AM. PICC complications in neonates and children. Journal of Vascular Access Devices. 1999: 17–26. It is clear that skin closure strips used to secure the peripherally inserted central catheter pose great risk and must never be applied directly over the catheter. Thank you for sharing this important information with your readers.

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

2020 ◽  
Vol 21 (6) ◽  
pp. 861-867 ◽  
Author(s):  
Emanuele Iacobone ◽  
Daniele Elisei ◽  
Diego Gattari ◽  
Luigi Carbone ◽  
Giuseppe Capozzoli
Keyword(s):  
Central Venous Catheter ◽  
Transthoracic Echocardiography ◽  
Venous Catheter ◽  
Atrial Arrhythmia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Bubble Test ◽  
Central Catheters

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia. Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray. Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05). Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

The Effects of 3 Peripherally Inserted Central Catheter Insertion Techniques in Chinese Patients With Different Vascular Status

2013 ◽  
Vol 18 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Ling Yuan ◽  
Rong Fu ◽  
Rong-Mei Li ◽  
Miao-Miao Guo ◽  
Xiang-Yu Chen
Keyword(s):  
Success Rate ◽  
The Other ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Ultrasound Guided ◽  
Insertion Technique ◽  
Significant Difference ◽  
Insertion Techniques ◽  
The Individual ◽  
Vascular Status

Abstract Objective: To provide evidence for selecting an appropriate peripherally inserted central catheter (PICC) insertion technique by comparing the insertion success rate and the incidence of complications with 3 PICC insertion techniques. Methods: We assigned enrolled patients to 3 groups according to the insertion technique selected by the individual patient: Group A, usual insertion technique (traditional, blind insertion); Group B, Modified Seldinger Technique (MST) insertion without ultrasound guidance; and group C, ultrasound-guided MST insertion. We compared the insertion success rate and the incidence of complications among these groups. Results: When comparing these 3 PICC insertion techniques, no significant difference was seen with respect to the insertion success rate and the incidence of catheter malposition (P > 0.05), although a significant difference existed in the incidence of bleeding at the insertion site after the PICC procedure (P < 0.05), with the ultrasound-guided MST insertion technique superior to the other 2 techniques; the incidence of mechanical phlebitis and catheter occlusion during the use of PICC had no significant difference among the 3 groups (P > 0.05); but a significant difference was seen in the incidence of thrombosis and catheter-related infections (P < 0.05), with a lower incidence in the ultrasound-guided MST insertion group than that in the other 2 groups. Conclusions: Ultrasound-guided MST insertion technique may address the problems occurring in patients with poor vascular access during the PICC procedure, whereas the usual insertion technique is the best choice for patients with good vascular access and poor economic status. Therefore, the selection of an appropriate insertion technique should be based on the economic and vascular status of the individual patient in clinical practice.

Prevalence of idle peripherally inserted central catheters in adult patients: A multicenter cross-sectional study

2019 ◽  
Vol 20 (6) ◽  
pp. 677-682 ◽  
Author(s):  
Zhao-Yu Xiong ◽  
Zhen Luo ◽  
Hai-Yan Chen
Keyword(s):  
Statistical Significance ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Cross Sectional ◽  
Peripherally Inserted Central Catheters ◽  
Vascular Access Devices ◽  
The Difference ◽  
Central Catheters

Background: Increasing studies concern about idle vascular access devices, but still scant data on idle peripherally inserted central catheters. We aimed to assess the prevalence and risks of idle peripherally inserted central catheters in adult patients. Methods: A multicenter cross-sectional observational study was performed between April 2018 and July 2018. Patient demographics and peripherally inserted central catheters–related information were abstracted using a site questionnaire by directly inquiring and medical records reviewing right after their peripherally inserted central catheters were removed. Results: Three hundred and fifty-eight patients with peripherally inserted central catheter episodes who met the inclusion criteria were studied. Of the 58,000 total catheter-days recorded, 5311 (9.2%) were considered as idle based on our study criteria. Two hundred and fifty-five (71.2%) patients had at least 1 idle catheter-day with a mean duration of 14.84 (19.31) idle days. The incidence of catheter-related complications in patients with idle peripherally inserted central catheters was lower than that in patients without idle peripherally inserted central catheters, though the difference did not reach statistical significance (odds ratio = 0.635, 95% confidence interval = 0.367–1.099, p = 0.103). Conclusion: In conclusion, idle peripherally inserted central catheters were common in adult patients, but the low risks of catheter-related complications may justify maintaining a peripherally inserted central catheter for further observation when necessary.

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