The Wandering Ways of a PICC Line: Case Report of a Malpositioned Peripherally Inserted Central Catheter (PICC) and Correction

2011 ◽  
Vol 16 (4) ◽  
pp. 218-220 ◽  
Author(s):  
J. Patricia Catudal ◽  
Elizabeth L. Sharpe
Keyword(s):  
Trisomy 21 ◽  
Term Infant ◽  
Infusion Therapy ◽  
Team Approach ◽  
X Rays ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Congenital Cardiac Anomalies ◽  
Picc Line ◽  
Central Catheters

Abstract Peripherally Inserted Central Catheters (PICC) are essential in modern infusion therapy. We describe a case of a full-term infant with Trisomy 21, congenital cardiac anomalies and sepsis, where the PICC became malpositioned. Noninvasive repositioning strategies were successfully utilized through a team approach, which enabled this unstable infant to complete their therapy course without the undue stress of inserting a new PICC or requiring additional X-Rays or more invasive replacement procedures.

Pericardial Effusion as a Complication of PICC Line Insertion

2021 ◽  
pp. 097321792110076
Author(s):  
Abdah Hrfi ◽  
Mohammed H.A. Mohammed ◽  
Omar Tamimi
Keyword(s):  
Birth Weight ◽  
Pericardial Effusion ◽  
Metabolic Diseases ◽  
Neonatal Period ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Preterm Baby ◽  
Line Insertion ◽  
Uncommon Condition ◽  
Picc Line

Cardiac tamponade as a result of pericardial effusion (PE) is a serious uncommon condition in the neonatal period. PE in such cases could be associated with hydrops fetalis, neonatal sepsis, metabolic diseases, or as a complication of percutaneous indwelling central catheter. 1 We are reporting a preterm baby, with low birth weight who developed large PE as a complication of total parenteral nutrition via a peripherally inserted central catheter, managed successfully with pericardiocentesis.

scholarly journals A dedicated peripherally inserted central catheter (PICC) line service: 2 Year review

2013 ◽  
Vol 11 (8) ◽  
pp. 649
Author(s):  
N.D. Appleton ◽  
A. Corris ◽  
C. Edwards ◽  
A. Kenyon ◽  
C.J. Walsh
Keyword(s):  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Picc Line

Peripherally Inserted Central Catheter Lines in the Behavioral Health Client: A Perspective

2006 ◽  
Vol 11 (3) ◽  
pp. 154-156
Author(s):  
Vera Deacon ◽  
Susan Oliver
Keyword(s):  
Behavioral Health ◽  
Chemotherapeutic Agents ◽  
Treatment Modalities ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Short Term ◽  
Hyperosmolar Solutions ◽  
Central Catheters ◽  
Indications For Use

Abstract Peripherally inserted central catheters (PICCs) are used in many different patient populations. The indications for use vary and include infusions of hyperalimentation, chemotherapeutic agents, hyperosmolar solutions, antibiotics, or long-term rehydration. However, on occasion, there are clients who do not fit the typical criteria for PICC insertion. This includes, but is not limited to, those individuals who are receiving frequent intravenous (IV) “sticks” or even short-term infusions of irritating drugs. The behavioral health client is one who may not be the typical PICC or IV patient but who may benefit from the placement of a PICC for certain treatment modalities.

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

scholarly journals An accuracy study of the Intracavitary Electrocardiogram (IC-ECG) guided peripherally inserted central catheter tip placement among neonates

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
Keyword(s):  
Logistic Regression ◽  
Lower Extremity ◽  
Dynamic Change ◽  
Multivariate Logistic Regression Analysis ◽  
X Rays ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
P Waves ◽  
Catheter Tip ◽  
Accuracy Study

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.

The Role of a Single Dose of Vancomycin in Reducing Clinical Sepsis in Premature Infants Prior to Removal of Peripherally Inserted Central Catheter: A Retrospective Study

2018 ◽  
Vol 35 (10) ◽  
pp. 990-993
Author(s):  
Lovya George ◽  
Michael Malloy ◽  
Rafael Fonseca ◽  
Vidit Bhargava
Keyword(s):  
Single Dose ◽  
Premature Infants ◽  
Exposed Group ◽  
P Value ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Clinical Sepsis ◽  
Picc Line ◽  
Culture Positive

Objective Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal. Methods A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed). The primary outcome measured was clinical sepsis with or without positive blood culture. Results The incidence of clinical sepsis in the exposed group was 7.3% compared with 6.3% in the nonexposed group (p-value: 0.7860). The incidence of culture-positive sepsis in the exposed group was 2.2% compared with 1.6% in the nonexposed group (p-value: 0.7673). The overall incidence of clinical and culture-positive sepsis in the subgroup with infants weighing <1,500 g and <32 weeks' gestational age was similar to the main study group. Conclusion Our data do not support routine vancomycin prophylaxis prior to PICC line removal in premature infants to prevent sepsis associated with PICC removal. However, a large randomized controlled trial is further needed to delineate these results.

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.

scholarly journals Persistent Left Superior Vena Cava Identified during Peripherally Inserted Central Catheter Line Placement

2019 ◽  
Vol 5 (02) ◽  
pp. 64-66
Author(s):  
Arvind Borde ◽  
Vivek Ukirde
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Anatomical Variant ◽  
Persistent Left Superior Vena ◽  
Line Placement ◽  
Picc Line

Abstract Introduction A persistent left superior vena cava (SVC) is found in 0.3 to 0.5% of the general population. It is seen in up to 10% of the patients with a congenital cardiac anomaly, being the most common thoracic venous anomaly, and is usually asymptomatic. Being familiar with such anomaly could help clinicians avoid complications during the placement of central lines, Swan-Ganz catheters, peripherally inserted central catheter (PICC) lines, dialysis catheters, defibrillators, and pacemakers. Case Presentation We describe a case of persistent left SVC which was noted after placement of a PICC line. A 5-year-old male child was hospitalized for evaluation and management of leukemia. He required PICC line placement for chemotherapy. He was noted to have a persistent left SVC during the procedure under fluoroscopic guidance and subsequently correct placement of PICC line in right SVC. Discussion This anatomical variant can pose iatrogenic risks if the clinician does not recognize it. A central catheter that tracks down the left mediastinal border may also be in the descending aorta, internal thoracic vein, superior intercostal vein, pericardiophrenic vein, pleura, pericardium, or mediastinum. Conclusion Our case is significant because the patient was diagnosed with double SVC on table only followed by the placement of PICC line into the right SVC. This case strongly demonstrates the importance of knowing the thoracic venous anomalies.

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.

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