Bedside insertion of a peripherally inserted central catheter into a patient with BMI of 84.8 kg/m2 using a magnetic tracking and electrocardiogram-based tip confirmation system: a case report

Uchida, Satoshi; Takekawa, Daiki; Hori, Masatoshi; Hashiba, Eiji; Hirota, Kazuyoshi

doi:10.1186/s40981-022-00559-8

Cited by 1 publication

(1 citation statement)

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“…In this case, the PICC can be inserted through the peripheral vein of the arm using ultrasound guidance. 35 PICC is a useful alternative for patients who have had renal transplants with neck vein thrombosis or multiple punctures that can cause chronic anemia or patients who are unable to be in a lying position due to severe pain or breathing difficulties. 36 37 …”

Section: Introductionmentioning

confidence: 99%

Anatomical Structures to Be Concerned With During Peripherally Inserted Central Catheter Procedures

Kim,

Park,

Cho

et al. 2023

J Korean Med Sci

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Background The central line has been frequently used for drug and nutrition supply and regular blood sampling of patients with chronic diseases. However, this procedure is performed in a highly sensitive area and has several potential complications. Therefore, peripherally inserted central catheters (PICC), which have various advantages, are being extensively used. Although the number of PICC procedures is increasing, the anatomy for safe procedures has not yet been properly established. Therefore, we studied basic anatomical information for safe procedures. Methods We used 20 fixed cadavers (40 arms) donated to the Korea University College of Medicine. The mean age was 76.75 years (range, 48–94 years). After dissection of each arm, the distribution pattern of the basilic vein and close structures was recorded, and some important parameters based on bony landmarks were measured. In addition, the number of vein branches (axillary region) and basilic vein diameter were also checked. Results The mean length from the insertion site to the right atrium was 38.39 ± 2.63 cm (left) and 34.66 ± 3.60 cm (right), and the basilic vein diameter was 4.93 ± 1.18 mm (left) and 4.08 ± 1.49 mm (right). The data showed significant differences between the left and right arms ( P < 0.05). The mean distance from the basilic vein to brachial artery was 8.29 ± 2.78 mm in men and 7.81 ± 2.78 mm in women, while the distance to the ulnar nerve was 5.41 ± 1.67 mm in men and 5.52 ± 2.06 mm in women. Conclusion According to these results, the right arm has a shorter distance from the insertion site to the right atrium, and the left arm has a wider vein diameter, which is advantageous for the procedure. In addition, the ulnar nerve and brachial artery were located close to or behind the insertion site. Therefore, special attention is required during the procedure to avoid damaging these important structures.

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Section: Introductionmentioning

confidence: 99%