Peripherally inserted central venous access

Lopez, Omar Nunez; Lorenc, Jamie M; Reading, B.; Juang, David; Aguayo, Pablo

doi:10.1016/j.sempedsurg.2021.151119

Cited by 7 publications

(3 citation statements)

References 64 publications

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“…If timely repositioning is not possible, the safety of the catheter can be confirmed by withdrawing blood, flushing the catheter, and reducing the osmotic pressure of the nutrient solution. Tracking the catheter tip position predictively and removing high-risk catheters as early as possible can maximize the prevention of complications ( 25 , 26 ), which is also consistent with Costa's view that complications of central venous catheters can be prevented ( 27 ).…”

Section: Discussionsupporting

confidence: 75%

The relationship between the PICC tip position and weight gain, length growth of premature infants under ultrasonography: a correlation analysis study

et al. 2023

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ObjectiveThis study aimed to analyze the correlation between PICC tip position and weight/length changes in preterm infants in different positions using ultrasonography.MethodsThe study is a prospective before and after self-control clinical trial. The study analyzed the distance between the PICC tip and the entrance of the heart under ultrasonography for premature infants who underwent PICC insertion. The infants were positioned and tracked weekly, and their weight and length were recorded. The Spearman rank correlation test was used to analyze the relationship between the displacement distance of the PICC tip under ultrasonography in different positions and weight/length changes.ResultsA total of 202 premature infants were included in the study, and 100% of them experienced changes in the PICC tip position. During the first week, 134 (66.33%) cases in a flexed position and 153 (75.74%) cases in a straight position showed displacement of the catheter toward the heart. The displacement distance of the tip during catheter retention was significantly correlated with weight change (rs = 0.681/0.661, P < 0.05) and length change (rs = 0.629/0.617, P < 0.05). In the third and fifth weeks, weight increased by 451 ± 178 and 750 (715–975) g, length increased by 1.50 (1.00–2.12) and 3.00 (2.00–3.70) cm, the catheter moved 1.27 ± 0.89 and 2.23 ± 0.95 cm, respectively, in a flexed position.ConclusionThe PICC tip position in preterm infants is influenced by weight and length changes. It is crucial to use ultrasonography to track and locate the catheter within the first week of placement and to increase the frequency of catheter localization starting from the third and fifth weeks. The flexed position is recommended during catheter localization.

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Section: Discussionsupporting

confidence: 75%

The relationship between the PICC tip position and weight gain, length growth of premature infants under ultrasonography: a correlation analysis study

et al. 2023

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“…The reason this study focused solely on the basilic vein is because the cephalic vein, an alternative, is too thin, has a high possibility of thrombosis, goes through the shoulder, causing movement of the catheter to increase, resulting in phlebitis 56 ; axillary vein is an option with a large diameter but is close to the brachial artery and is covered with a thick subcutaneous fat layer 57 ; the brachial vein, another alternative, has a higher possibility of damaging the median and anterior interosseous nerves or the brachial artery when injecting a needle, 38 58 59 60 thus the basilic vein is most commonly used. However, depending on the state of the patient’s basilic vein, the cephalic or brachial veins are sometimes used; therefore, further research on these veins is needed.…”

Section: Discussionmentioning

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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“…e study was approved by the Ethics Committee of Hunan Children's Hospital. e inclusion criteria were as follows: (1) all subjects in this study met the relevant clinical criteria by referring to the PICC Placement and Maintenance Manual [3]; (2) all patients and their families selected for the study voluntarily signed their consent and were approved by the Medical Ethics Committee. e exclusion criteria are as follows: (1) the child has severe coagulation disorders; (2) the child had developed complications such as infections; (3) the child had severe allergic reactions to medication or medical devices used; (4) the child had a history of phlebitis or venous thrombosis; (5) the child had a mental illness or cognitive impairment that prevents him/her from cooperating effectively with health care professionals in the treatment and intervention.…”

Section: Methodsmentioning

confidence: 99%

An Information‐Based Nursing Quality Evaluation Model of Daily PICC Work in Outpatient Clinics

Chen

et al. 2022

Contrast Media & Molecular Imaging

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Our purpose of this study was to analyze the application value of the information-based nursing quality evaluation model in improving the daily work quality of the PICC room in the outpatient department. From January 2020 to December 2020, 465 patients who received PICC treatment were selected as the research objects and divided into the observation group (265 cases, July 2020–December 2020, information-based nursing quality evaluation model after implementation) and the control group (200 cases, January 2020–June 2020, before the implementation of the information-based nursing quality assessment model). Compared with the control group, the children and their families in the observation group had higher PICC health knowledge and compliance scores, longer mean time for catheter placement, lower overall complication rate, and higher overall satisfaction rate after the intervention. The information-based nursing quality evaluation model can improve the daily work quality of the PICC room in the outpatient clinic, improve the clinical efficacy of PICC in patients, and reduce the incidence of complications such as catheter shedding. It is worthy of clinical application.

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Peripherally inserted central venous access

Cited by 7 publications

References 64 publications

The relationship between the PICC tip position and weight gain, length growth of premature infants under ultrasonography: a correlation analysis study

The relationship between the PICC tip position and weight gain, length growth of premature infants under ultrasonography: a correlation analysis study

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

An Information‐Based Nursing Quality Evaluation Model of Daily PICC Work in Outpatient Clinics

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