The upper arm approach for placement of peripherally inserted central catheters for protracted venous access.

1992 ◽  
Vol 158 (2) ◽  
pp. 427-429 ◽  
Author(s):  
J C Andrews ◽  
M V Marx ◽  
D M Williams ◽  
I Sproat ◽  
S C Walker-Andrews
Keyword(s):  
Venous Access ◽  
Upper Arm ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

Comparison of Outcomes of Extended Dwell/Midline Peripheral Intravenous Catheters and Peripherally Inserted Central Catheters in Children

2016 ◽  
Vol 21 (3) ◽  
pp. 158-164 ◽  
Author(s):  
Jill Anderson ◽  
Angela Greenwell ◽  
Jill Louderback ◽  
Barbara J. Polivka ◽  
Jodi Herron Behr
Keyword(s):  
Decision Tree ◽  
Care Facility ◽  
Venous Access ◽  
Peripherally Inserted Central Catheters ◽  
Included Patient ◽  
Category Type ◽  
Catheter Size ◽  
Venous Access Device ◽  
Record Review ◽  
Central Catheters

Abstract Background: Insertion of extended dwell/midline peripheral intravenous (EPIVs) catheters is not common practice in pediatric hospitals. An interdisciplinary team in 1 pediatric hospital developed a venous access decision tree based on current standards that included EPIVs. The purpose of this evaluation was to assess the process and pediatric patient outcomes associated with use of EPIVs and with peripherally inserted central catheters (PICCs). Methods: A retrospective record review over 22 months was conducted for 375 patients who received either a PICC (67.5%) or EPIV (32.5%). Data collected included patient demographic characteristics, diagnosis category, type and purpose of the line, insertion and removal dates, catheter size, placement location, and complications encountered. Results: EPIVs were inserted with a 1.9F or 3F catheter, whereas PICCs generally used a 3F or 4F catheter. EPIVS were more commonly inserted in children younger than age 1 year, whereas children aged ≥ 11 years more often had a PICC inserted. EPIVs remained in place an average of 9 days compared with 20 days for PICC lines. Significantly more complications occurred during the placement of PICCs, whereas EPIVs had more complications during use such as leakage, dislodging, and infiltration. Conclusions: EPIVs were a successful alternative to PICC or peripherally inserted venous catheters for children in an inpatient acute-care facility who need 30 days or fewer of nonvesicant intravenous therapy. The venous access decision tree provided useful guidance in determining the appropriate venous access device for pediatric patients and the decision tree was adhered to by the vascular access team.

Sharp Recanalization of a Chronically Occluded Superior Vena Cava in a Patient with Multiple Prior Peripherally Inserted Central Catheters

2019 ◽  
Vol 24 (2) ◽  
pp. 21-26
Author(s):  
Omar Shwaiki ◽  
Sarah Khoncarly ◽  
James J. Buchino ◽  
Janice McDaniel
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Collateral Flow ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Sharp Recanalization ◽  
Central Catheters

Highlights Recurrent central venous access can lead to central venous occlusions. Collateral flow can be used adventitiously for PICC tip placement. Sharp recanalization can be used to reconstitute patency of an occluded SVC.

Peripherally inserted central catheters: dependency of radiation exposure from puncture site and level of training

2017 ◽  
Vol 59 (6) ◽  
pp. 688-693 ◽  
Author(s):  
Martin Jonczyk ◽  
Bernhard Gebauer ◽  
Dirk Schnapauff ◽  
Roman Rotzinger ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Venous Access ◽  
Puncture Site ◽  
Access Site ◽  
Peripherally Inserted Central Catheters ◽  
P Values ◽  
Chest Port ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Level Of Training ◽  
Central Catheters

Background Several interventional procedures show a dependency on fluoroscopy times (FT) and level of training. Furthermore, FT and dose area products (DAP) vary depending on access site and target vessel for chest port implantations, but not for other thoracic interventions such as percutaneous coronary interventions. Purpose To evaluate the influence of the combination of venous access site and level of training on FTs and DAPs during peripherally inserted central catheters (PICC) implantations in a large cohort of patients. Material and Methods In this retrospective study, PICC implantations of 681 consecutive patients (385 women, 296 men; mean age = 55.0 ± 16.7 years) were analyzed. Two groups of junior (< 50 interventions) and senior (≥ 50 implantations) radiologists were investigated in respect to FT and DAP during PICC placement procedures. Statistical analysis included the Mann–Whitney U test and the Kruskal–Wallis test. P values < 0.05 were considered significant. Results Senior radiologists required significantly less FT (senior = 0.43 s, junior = 0.53 s, P = 0.041), but there was no significant difference in DAPs (senior = 56.3 µGy*m2, junior = 60.6 µGy*m2, P = 0.151). PICC implantations through the left side resulted in a significant reduction of the median FT by 60.9% (left = 0.45 s, right = 1.15 s, P = 0.010). Conclusion Due to considerable dose reduction, the left-sided puncture, especially via the basilic and brachial veins, performed by well-trained interventional radiologists seem to be the preferable approach for PICCs.

In defense of the use of peripherally inserted central catheters in pediatric patients

2020 ◽  
pp. 112972982093641
Author(s):  
Alessandro Crocoli ◽  
Simone Cesaro ◽  
Monica Cellini ◽  
Francesca Rossetti ◽  
Luca Sidro ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Late Complications ◽  
Central Venous ◽  
Central Venous Access Device ◽  
Peripherally Inserted Central Catheters ◽  
Non Invasive ◽  
Venous Access Device ◽  
Central Catheters ◽  
Venous Access Devices

Central venous access devices have revolutioned the care of children affected by malignancies, facilitating management of complex and prolonged infusive therapies, reducing pain and discomfort related to repeated blood samples and indiscriminate venipunctures, thus reducing also psychological stress of both patients and families. In this respect, peripherally inserted central catheters have been disseminated for use, even in pediatric oncology patients, for their many advantages: easy and non-invasive placement with no risk of insertion-related complications, as well as easy removal; reduced need for general anesthesia both for insertion and removal; adequate prolonged performance also for challenging therapies (e.g. stem cell transplantation); and low rate of late complications. Nonetheless, concerns have been recently raised about use of such devices in children with cancer, especially regarding a presumed (but not demonstrated) high risk of catheter-related venous thrombosis. Are we facing a new witch (or peripherally inserted central catheter) hunt? The choice of the central venous access device—particularly in oncologic children—should be based on an evaluation of clinical advantages and risks, as provided by appropriate and scientifically accurate clinical studies.

Placement of Peripherally Inserted Central Catheters (PICC): The Upper Arm Approach

1995 ◽  
Vol 33 (6) ◽  
pp. 861 ◽  
Author(s):  
Jae Hoon Lim ◽  
Jung Hwan Yoon ◽  
Sung Wook Choo ◽  
In Wook Choo ◽  
Dong II Choi ◽  
...  
Keyword(s):  
Upper Arm ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters
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