Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy

S, Nakamuta; Nishizawa, Toshihiro; Matsuhashi, Shiori; Shimizu, Arata; Uraoka, Toshio; Yamamoto, Masato

doi:10.1177/1129729818765057

Cited by 15 publications

(16 citation statements)

References 17 publications

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“…During the PICC placement procedure, the most problematic parts were venous access and catheter tip positioning. In our study, the overall venous access success rate was 98.6%, which is similar to previous reports (91%-100%) that used ultrasound guidance [16,17]. In our study, the failure rate was almost double with the blind technique (2.9%) compared to the ultrasound guidance technique (1.4%).…”

Section: Discussionsupporting

confidence: 89%

Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

et al. 2020

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Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution Background: Bedside insertion of peripherally inserted central catheters (PICCs) has higher rates of malposition than fluoroscopic-guided PICC placement. This study evaluated the success rate of bedside PICC placement, variations in tip location, and risk factors for malposition. Methods: This retrospective study included patients who underwent bedside PICC placement from January 2013 to September 2014 in a single institution. The procedure was conducted under ultrasound guidance or by a blind method. After PICC placement, tip location was determined by chest X-ray. Results: The overall venous access success rate with bedside PICC placement was 98.1% (1,302/ 1,327). There was no significant difference in the venous access success rate between ultrasound-guided placement (868/880, 98.6%) and a blind approach placement (434/447, 97.1%). Optimal tip position was achieved on the first attempt in 1,192 cases (91.6%). Repositioning was attempted in 65 patients; 60 PICCs were repositioned at the bedside, two PICCs were repositioned under fluoroscopic guidance, and three PICCs moved to the desired position without intervention. Final optimal tip position after repositioning was achieved in 1,229 (94.4%). In logistic regression analysis, five factors associated with tip malposition included female sex (Exp(B), 1.687; 95% confidence interval [CI], 1.180 to 2.412; P=0.004), older age (Exp(B), 1.026; 95% CI, 1.012 to 1.039; P < 0.001), cancer (Exp(B), 0.650; 95% CI, 0.455 to 0.929; P = 0.018), lung disease (Exp(B), 2.416; 95% CI, 1.592 to 3.666; P < 0.001), and previous catheter insertions (Exp(B), 1.262; 95% CI, 1.126 to 1.414; P < 0.001). Conclusions: Bedside PICC placement without fluoroscopy is effective and safe in central venous catheters. Potential risk factors associated with catheter tip malposition include older age, female sex, cancer, pulmonary disease, and previous central vein catheterizations.

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Section: Discussionsupporting

confidence: 89%

Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

et al. 2020

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“…Other authors have also recorded a lower sensitivity of the method, in particular of TTE with bubble test. 4,6 This is probably due to the limited number of tip malposition or the imperfect accuracy of the chest X-ray taken as a reference technique. 5…”

Section: Discussionmentioning

confidence: 99%

“…This is the first study that evaluated TTE for tip location in PICC catheters. Recently, Nakamuta et al 16 have evaluated the tip location of PICC by ultrasound, but they have not used TTE with bubble test. These authors used vascular ultrasound to exclude the wrong position of the tip, evaluating the absence of the catheter tip in the jugular and axillary veins.…”

Section: Discussionmentioning

confidence: 99%

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

et al. 2020

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Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia. Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray. Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05). Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

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“…Peripherally inserted central venous catheter (PICC) is widely used in chemotherapy and nutritional support for tumor patients. [ 1 – 4 ] The infusion of chemotherapeutic drugs through PICC can reduce the risk of drug extravasation and the stimulation of peripheral blood vessels, avoid the pain caused by repeated puncture, and greatly improve the quality of life of cancer patients. [ 5 – 7 ] However, the blood of tumor patients is mostly in a state of hypercoagulability or vascular endothelial damage due to the influence of long-term chemotherapeutic drugs.…”

Section: Introductionmentioning

confidence: 99%

Relationship between ABO blood group and risk of venous thrombosis in cancer patients with peripherally inserted central catheters

Liu

Qiang

et al. 2020

Medicine

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Background: Peripherally inserted central catheter (PICC) is closely related to venous thromboembolism (VTE). It is a common complication of hospitalized patients, and its etiology is complex. How to prevent the occurrence of VTE is the focus of clinical work. In order to provide basis for individual prevention and accurate treatment of VTE, the purpose of this study was to explore the relationship between ABO blood group and the risk of VTE in cancer patients associated with PICC through meta-analysis. Methods: Electronic databases, including Embase, Cochrane Library, Pubmed, Chinese databases SinoMed, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Data, were searched for case-control studies of ABO blood group and PICC-related VTE in cancer patients. The languages were limited to Chinese and English. Two reviewers were responsible for the selection of the study, the extraction of data and the evaluation of the quality of the research. All statistical analyses were carried out with Review Manager 5.3 and Stata 14.0. Results: The results of this meta-analysis would be published in peer-reviewed journals. Conclusion: This study provided evidence to support the relationship between ABO blood group and the risk of PICC-related VTE in cancer patients. OSF Registration number: DOI 10.17605/OSF.IO/6DPFG

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Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy

Abstract: 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.

Cited by 15 publications

References 17 publications

Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia

Relationship between ABO blood group and risk of venous thrombosis in cancer patients with peripherally inserted central catheters

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