Impact of body posture change on peripherally inserted central catheter tip position in Chinese cancer patients

2020 ◽  
Vol 21 (5) ◽  
pp. 732-737
Author(s):  
Chunli Liu ◽  
Dingbiao Jiang ◽  
Tao Jin ◽  
Chuanyin Chen ◽  
Ruchun Shi ◽  
...  
Keyword(s):  
Upright Position ◽  
Body Posture ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Posture Change ◽  
Body Change ◽  
Catheter Tip ◽  
The Mean ◽  
Tip Position ◽  
Chinese Cancer Patients

Purpose: To evaluate the influence of body posture change on the peripherally inserted central catheter tip position in Chinese cancer patients. Methods: A prospective observational trial was conducted in a tertiary cancer hospital from August to September 2018. After the insertion of peripherally inserted central catheter, chest X-ray films were taken to check the catheter tip in the upright and supine positions, respectively. The distance from the carina to the catheter tip was separately measured on both chest films by nurses. The primary study outcome was the distance and direction of the catheter tip movement. The secondary study outcome was to analyze the influence factors on the catheter tip movement. The third study outcome was to observe the related adverse events caused by the catheter tip movement. Results: A total of 79 patients were included, the results showed that 61 moved cephalad, 14 moved caudally, and 4 did not move with body change from the supine to the upright position. When moved cephalad, the mean distance was 19.34 ± 11.95 mm; when moved caudally, the mean distance was –15.83 ± 8.97 mm. The difference between the two positions was statistically significant ( p < 0.001). There was also a statistically significant difference between catheter tip movement direction and body mass index ( p = 0.009) and height ( p = 0.015). Two patients developed arrhythmias; no cardiac tamponade was found due to body posture change. Conclusion: The results of this work implied that the tips of the catheter tend to shift toward the cephalad with body change from the supine to the upright position. A study involving a larger sample size is needed to find more information in the future.

Excellent inter-observer agreement between radiologist and nurse: tracheal carina-based identification of peripherally inserted central catheter tip position

2018 ◽  
Vol 19 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Xiaoxia Zhang ◽  
Dan Jia ◽  
Nengwen Ke ◽  
Chang Liu ◽  
Lan Fu ◽  
...  
Keyword(s):  
Border Region ◽  
Observer Agreement ◽  
Central Vein ◽  
Emergency Setting ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Accurate Identification ◽  
Catheter Tip ◽  
Tip Position ◽  
Tracheal Carina

Introduction: Accurate identification of position of a central venous catheter tip is important to reduce catheter-related complications. Nevertheless, inter-observer bias limits the accuracy of traditional method for determining tip position on chest x-ray (CXR) images. The aim of this study was to explore a simple and objective method for assessing position of peripherally inserted central catheter (PICC) tip on CXR image. Methods: Tracheal carina was used as the landmark to identify positions of catheter tips. The central vein (CV) was located between 3 cm above and 4 cm below tracheal carina. The vertical distance from catheter tips to tracheal carina was measured independently by a nurse and re-assessed by a radiologist. Inter-observer agreement was expressed as percentage in agreement and kappa coefficient. Results: Six hundred and twelve CXR images of catheters taken from 612 patients were included. The inter-observer agreement between nurse and radiologist was 97.88% (kappa = 0.934) for all catheter tips evaluated, and 98.40% (kappa = 0.923) for catheter tips with regard to CV, innominate vein, and right atrium. Most discrepancies (9/13) between observers occurred when catheter tips were positioned in a border region between different anatomical parts. Conclusions: Inter-observer agreement between nurse and radiologist is excellent. Our results demonstrate that the measurement of distance between catheter tip and tracheal carina performed by a nurse provide a convenient and reliable way to determine position of PICC tip. Our study also suggests that nurses can be trained to handle PICCs, especially when properly located catheters are applied in critically ill patients during emergency setting.

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.

Peripherally inserted central catheter malposition to a persistent left superior vena cava: A successful case to leave the catheter till the end of chemotherapy

2020 ◽  
pp. 112972982093820
Author(s):  
Qi Li ◽  
Yuxiu Liu ◽  
Min Wang ◽  
Zhongjie Yu ◽  
Yufang Gao
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Catheter Insertion ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Catheter Tip ◽  
Tip Position

Persistent left superior vena cava is rare and asymptomatic and is usually discovered incidentally during or after insertion of a central venous catheter. There is uncertainty as to whether or not the catheter should be removed after its malposition resulting in persistent left superior vena cava. We reported an unusual case of a breast cancer patient with a persistent left superior vena cava detected after a peripherally inserted central catheter insertion. The patient had undergone a modified radical mastectomy and needed to insert a peripherally inserted central catheter for chemotherapy. After the peripherally inserted central catheter insertion, the chest X-ray and computed tomography showed that the catheter was located in the persistent left superior vena cava. After an assessment of the persistent left superior vena cava and the catheter tip position, the peripherally inserted central catheter remained in the persistent left superior vena cava for further therapy. To ensure the integrity of the catheter, special follow-ups and tip position observations were carried out. The peripherally inserted central catheter was safe until the end of chemotherapy with no complications. Although the peripherally inserted central catheter tip was located in persistent left superior vena cava, given that the persistent left superior vena cava coexisted with a right superior vena cava with the similar lumen, the peripherally inserted central catheter could be used normally under strict attention.

Peripherally Inserted Central Catheter Tip Position: A Novel Empirical-Ultrasonographical Index in a Modern Surgical Oncology Department

2013 ◽  
Vol 21 (2) ◽  
pp. 656-661 ◽  
Author(s):  
Luigi Marano ◽  
Giuseppe Izzo ◽  
Giuseppe Esposito ◽  
Marianna Petrillo ◽  
Angelo Cosenza ◽  
...  
Keyword(s):  
Surgical Oncology ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip ◽  
Tip Position

scholarly journals Defining peripherally inserted central catheter tip position and an evaluation of insertions in one unit

Anaesthesia ◽  
2013 ◽  
Vol 68 (5) ◽  
pp. 484-491 ◽  
Author(s):  
A. J. Johnston ◽  
S. M. Bishop ◽  
L. Martin ◽  
T. C. See ◽  
C. T. Streater
Keyword(s):  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip ◽  
Tip Position

Diagnosis and management of secondary malposition of PICC into the azygos vein

2021 ◽  
pp. 112972982199948
Author(s):  
Yaping Wang ◽  
Linfang Zhao
Keyword(s):  
Azygos Vein ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Close Attention ◽  
Diagnosis And Management ◽  
Catheter Dysfunction ◽  
Left Limb ◽  
Catheter Tip ◽  
Tip Position ◽  
The Right

Background: Peripherally inserted central catheter (PICC) has been widely used. The catheter-related complications might occur and the reports of secondary malposition into azygos veins were rare. Methods: This retrospective review summarized the experience in diagnosis and management of secondary malposition of PICC into azygos veins in 25 cases. Results: When the catheter dysfunction occurred in the PICC on the left limb, it was necessary to consider whether there would be malposition into azygos veins after other reasons were excluded. The malposition could be diagnosed by chest lateral radiograph or chest computed tomography. The secondary malposition into azygos veins was resolved by repositioning or withdrawing the PICC. After re-inserting the catheter, it should be closely monitored whether the malposition occurred again. Intracavitary electrocardiogram positioning technology was used to confirm the catheter tip position before using corrosive drug. After the catheters withdrawn from the azygos veins, close attention should be paid to the property and concentration of the infusion drug strictly and the complications such as blockage and re-malposition. No serious complications such as infection, thrombosis and extravasation occurred in this group of patients after treatment. Conclusions: The results of our study suggested that the right limb is recommended for PICC catheterization in order to avoid secondary malposition into azygos veins and the malposition into azygos veins should be dealt with in time.

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