Inadvertent Catheterization of the Ascending Lumbar Vein

2009 ◽  
Vol 28 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Carol Trotter
Keyword(s):  
Contrast Material ◽  
Spinal Column ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Contrast Injection ◽  
Venous Plexus ◽  
Central Venous ◽  
X Ray ◽  
Lumbar Vein ◽  
Ascending Lumbar Vein

A NUMBER OF SERIOUS COMPLICATIONS can arise from malpositioned central venous catheters (CVCs), including cardiac tamponade and perforation, pleural effusions, and infusion into the vertebral venous system anywhere along the spinal column. Figure 1 is an x-ray of a premature infant taken after insertion of a 2.0 Silastic peripherally inserted central catheter (PICC), demonstrating the catheter entering the left ascending lumbar vein (ALV). Routine contrast injection of 0.3 mL of iothalamate meglumine 60 percent (Conray, Covidien Imaging Solutions, Hazelwood, Missouri) at the time of the PICC-placement film demonstrated that the contrast material extended into the vertebral venous plexus. The catheter was immediately withdrawn before intravenous fluid was administered, and the infant experienced no complications.

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.

Severe cutaneous necrotizing vasculitis with postinfectious glomerulonephritis secondary to peripherally inserted central catheter bloodstream infection

2020 ◽  
pp. 112972982097078
Author(s):  
Francesco Londrino ◽  
Antonio Granata ◽  
Slave Boiceff ◽  
Massimo Guadagni ◽  
Sara Dominijanni ◽  
...  
Keyword(s):  
Term Therapy ◽  
Peripherally Inserted Central Catheter ◽  
Necrotizing Vasculitis ◽  
Central Catheter ◽  
Central Venous ◽  
Safe Alternative ◽  
Postinfectious Glomerulonephritis ◽  
Long Term Therapy ◽  
Central Catheters

Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particularly in the oncological and hematological field. PICCs are a safe alternative to central venous catheters, mainly for medium- and long-term therapy

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.

The Use of CT Imaging Technology in Peripherally Inserted Central Catheter

2021 ◽  
Vol 11 (1) ◽  
pp. 114-119
Author(s):  
Ying Wu ◽  
Guohua Huang ◽  
Qiufeng Li ◽  
Jinai He
Keyword(s):  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Ct Imaging ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Imaging Technology ◽  
X Ray ◽  
The Right

Objective: The objective is to explore the application of computed X-ray tomography (CT) imaging technology in peripherally inserted central catheter (PICC), and to propose a more effective method for PICC catheterization. Method: In this study, 69 subjects are divided into the observation group (X-ray and CT) and the control group (X-ray). The guiding effect of CT images on PICC tube placement in complex cases is compared. In this study, CT localization of the superior vena cava–caval-atrial junction (CAJ) is used as the gold standard. The position relationship of carina-CAJ and carina-PICC catheter tip is measured and analyzed by CT image and chest radiography (CXR) image, providing scientific basis for PICC tip imaging. Results: After this study, the tip of the catheter should be 1/3 of the middle and lower part of the superior vena cava, about 3 cm above the junction of the right atrium and the superior vena cava, and in the upper part of the diaphragm of the inferior vena cava, so that it cannot enter the right ventricle or the right atrium. The best position of the tip of the catheter is near the junction of the superior vena cava and the right atrium. The average vertical distance between the tracheal carina and CAJ is 4.79 cm. Conclusion: CT and X-ray examination can effectively determine the location of the tip of PICC catheter in cancer chemotherapy patients, but the clarity of X-ray examination is missing. It is suggested to adopt CT examination, and further adopt and promote it.

scholarly journals Cateter central de inserção periférica: contribuições para a enfermagem oncológica

2019 ◽  
Vol 13 (3) ◽  
pp. 715
Author(s):  
Dandara Costa Alcântara ◽  
Cristiano Bertolossi Marta ◽  
Antonio Augusto Freitas Peregrino ◽  
Ana Paula Siqueira ◽  
Priscilla Oliveira Silva ◽  
...  
Keyword(s):  
Patient Comfort ◽  
Oncology Nursing ◽  
Complication Rates ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Study Type ◽  
Care Nursing ◽  
Nursing Professional ◽  
Selection Of

RESUMOObjetivo: analisar as evidências acerca dos cuidados para o correto uso do cateter central de inserção periférica pelo enfermeiro ao paciente portador de câncer. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa. Realizou-se a busca de artigos científicos nas bases de dados LILACS, BDENF e a MEDLINE, publicados entre os anos de 2010 a 2016. Apresentam-se os resultados em forma de tabela e figuras. Resultados: encontraram-se 422 artigos, analisaram-se 175 e, destes, 15 foram selecionados. Elencaram-se duas categorias para discussão: a importância do conhecimento do profissional de Enfermagem para o uso do PICC/CCIP e a segurança do paciente por meio da prática segura. Conclusão: concluiu-se que, devido à autonomia do enfermeiro, respaldada pela lei, às indicações de uso, ao conforto proporcionado aos pacientes, aos benefícios para os profissionais, ao custo-efetividade e às baixas taxas de complicações, a seleção do PICC/CCIP no tratamento de pacientes oncológicos é uma opção muito inteligente e confiável, porém, o enfermeiro deve estar atento ao aperfeiçoamento do conhecimento de toda a equipe de Enfermagem. Descritores: Oncologia; Enfermagem Oncológica; Cateteres Venosos Centrais; Cuidados de Enfermagem; Enfermagem; Cateteres.                             ABSTRACT Objective: to analyze the evidence about the care for the correct use of the Peripherally inserted central catheter by the nurse to the patient with cancer. Method: this is a bibliographical study, type integrative review. Scientific articles were searched in the databases LILACS, BDENF and MEDLINE, published between the years 2010 and 2016. The results are presented in table and figure form. Results: 422 articles were found, 175 were analyzed and, of these, 15 were selected. Two categories were listed for discussion: the importance of nursing professional knowledge for the use of PICC and patient safety through safe practice. Conclusion: it was concluded that due to the autonomy of the nurse, supported by the law, the indications of use, patient comfort, benefits for professionals, cost-effectiveness and low complication rates, selection of PICC in the treatment of cancer patients is a very intelligent and reliable option, however, the nurse must be attentive to the improvement of the knowledge of the entire nursing team. Descriptors: Oncology; Nursing Oncology; Central Venous Catheters; Nursing care; Nursing; Catheters.                         RESUMEN Objetivo: analizar las evidencias acerca de los cuidados para el correcto uso del catéter central de inserción periférica por el enfermero al paciente portador de cáncer. Método: se trata de un estudio bibliográfico, tipo revisión integrativa. Se realizó la búsqueda de artículos científicos en las bases de datos LILACS, BDENF y MEDLINE, publicados entre los años 2010 a 2016. Se presentan los resultados en forma de tabla y figuras. Resultados: se encontraron 422 artículos, se analizaron 175 y, de éstos, 15 fueron seleccionados. Se establecieron dos categorías para discusión: la importancia del conocimiento del profesional de Enfermería para el uso del PICC / CCIP y la seguridad del paciente por medio de la práctica segura. Conclusión: se concluyó que, debido a la autonomía del enfermero, respaldada por la ley, a las indicaciones de uso, al bienestar proporcionado a los pacientes, a los beneficios para los profesionales, al costo-efectividad y a las bajas tasas de complicaciones, la selección del PICC / CCIP en el tratamiento de pacientes oncológicos es una opción muy inteligente y confiable, sin embargo, el enfermero debe estar atento al perfeccionamiento del conocimiento de todo el equipo de Enfermería. Descriptores: Oncología Médica, Enfermería Oncológica, Catéteres Venosos Centrales, Atención de Enfermería; Enfermería; Catéteres.             

Impact of number of lumens in central-venous catheters on central-line bloodstream infection (CLABSI) and venous thromboembolism (VTE) risk in patients with acute leukemia

2021 ◽  
pp. 1-3
Author(s):  
Alina Varabyeva ◽  
Christabel Pui-See Lo ◽  
Adamo Brancaccio ◽  
Anthony J. Perissinotti ◽  
Twisha Patel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Venous Thromboembolism ◽  
Acute Leukemia ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Catheters ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Double Lumen

Abstract This retrospective study was conducted to determine whether the number of peripherally inserted central-catheter lumens affected the rate of central-line associated bloodstream infections (CLABSIs) in adult patients with acute leukemia. The results show that CLABSI rates were not significantly different between patients with triple-lumen or double-lumen PICCs (22.1% vs 23.4%; P = .827).

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