The Role of Saline Flush Injection Rate in Displacement of CT-Injectable Peripherally Inserted Central Catheter Tip During Power Injection of Contrast Material

2014 ◽  
Vol 202 (1) ◽  
pp. W13-W18 ◽  
Author(s):  
Peter Morden ◽  
Farnoosh Sokhandon ◽  
Laura Miller ◽  
Michael Savin ◽  
Matthias Kirsch ◽  
...  
2005 ◽  
Vol 53 (1) ◽  
pp. S127.1-S127
Author(s):  
P. Fliman ◽  
R. deRegnier ◽  
M. DeUngria ◽  
R. Shore ◽  
R. Steinhorn

2009 ◽  
Vol 28 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Carol Trotter

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 The catheter was immediately withdrawn before intravenous fluid was administered, and the infant experienced no complications.


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Keline Soraya Santana Nobre ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Juliana Lopes Teixeira ◽  
Márcia Maria Coelho Oliveira Lopes ◽  
Fernanda Cavalcante Fontenele

Aim:  analyze  the  use  of  peripherally  inserted  central  catheter  in terms of the aspects of technique, positioning and maintenance, as well as the influence on the number of venous dissections in hospitalized infants in a neonatal unit. Method: descriptive,  retrospective,  quantitative  study,  in  reference  maternity  unit  of  a  city  in northeastern  Brazil.  Sample  composed  of  1,599  peripherally  inserted  central  catheter insertions in 1,204 infants during the years 2006 to 2013. Instruments were used that recorded  aspects  of  the  insertion  of  peripherally  inserted  central  catheter  and  venous dissection.  Results:  most  babies  were  premature,  of  low  birth  weight  and  male.  The veins  of  the  cubital  region  were  the  most  punctured  with  insertion  success  until  the fourth  puncture.  The  central  positioning  of  the  catheter  tip predominated,  with  a permanency  time  between  11  and  20  days,  removing  it  at  the  end  of  the  treatment. Over  the  years,  the  number  of  venous  dissections  was  inversely  proportional  to  the insertion  of  peripherally  inserted  central  catheter.  Conclusion:  this  transvenous  device was  shown  to  be  important  for  the  treatment  of  hospitalized  newborns,  favoring reduction of venous dissections.


2020 ◽  
Vol 21 (5) ◽  
pp. 732-737
Author(s):  
Chunli Liu ◽  
Dingbiao Jiang ◽  
Tao Jin ◽  
Chuanyin Chen ◽  
Ruchun Shi ◽  
...  

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.


Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Lian-juan Zhou ◽  
Hong-zhen Xu ◽  
Mei-fang Xu ◽  
Yan Hu ◽  
Xiao-Fang Lou

AbstractObjectiveTo explore the clinical application of the intracavitary electrocardiogram (IC-ECG) guided Peripherally Inserted Central Catheter (PICC) tip placement among neonates.Backgroundthe ECGs of neonates are difficult to perform and their wave shapes are of doubtful accuracy due to various interfering factorsMethod115 neonates were admitted to perform PICC guided by IC-ECG. Logistic regression was performed to analyze all possible influencing factors of the accuracy from the tip placement. The puncture site of the PICC, gestational age, height, weight, basal P/R amplitude and positioning P/R amplitude might be related to the accuracy of IC-ECG location.ResultThe accuracy in the lower extremity was higher than that in the upper extremity. Multivariate logistic regression analysis showed that the weight (Odds Ratio (OR)=1.93, 95%Confidence Interval(CI):1.06-3.50) and positioning P/R amplitude (OR=32.33, 95%CI: 2.02-517.41) are statistically significant risks to the accuracy PICC tip placement.ConclusionsPossible methods to improve the accuracy might be Catheterizing through lower extremity, keeping the neonates calm, enhancing the electrocardiogram signal and strengthening technical training. Therefore it is practical to perfrom a tip placement by the dynamic change in the P waves from an electrocardiogram (ECG) guided PICC among neonates and as reliable as using X-rays.


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