Safety and Efficacy of Peripherally Inserted Central Catheter Placement by Surgical Intensivist–Led Vascular Access Team

Yu, Byunghyuk; Hong, Joo-Heon

doi:10.5758/vsi.220054

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…Previous studies have underscored the significance of accurate PICC placement to mitigate the risks of malpositioning, and some of the commonly reported techniques for enhancing precision include ultrasound guidance and electrocardiography verification [ 1 - 3 ]. There is extensive literature on the safety of PICC placement, predominantly within the intensive care unit (ICU) setting [ 4 , 5 ]. However, questions persist regarding the feasibility of such procedures in environments characterized by limited resources and heightened procedural challenges, such as communicable disease isolation rooms.…”

Section: Introductionmentioning

confidence: 99%

Precision at the Bedside: Practical Efficacy of Clockwise Catheter Torque for Accurate Tip Positioning of Peripherally Inserted Central Catheters

Akatsuka,

Sugiyama

2023

Cureus

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Precise placement of peripherally inserted central catheters (PICCs) is essential for avoiding treatment risks and ensuring the success of treatment. This is typically performed under imaging guidance, but imaging modalities may not be accessible under resource-limited settings or alternative settings such as communicable disease isolation rooms. Here, we have proposed a new technique for the precise placement of PICCs through the application of clockwise torque. Application of the PICC with this technique in our patient resulted in the precise insertion of the catheter. As this method eliminates the need for imaging modalities, it has promise for application at the bedside and in resource-limited settings. Importantly, it presents a new aspect of catheterization protocols that could hold immense potential for the future. In the future, its efficiency needs to be verified in a larger number of patients under different settings and from different populations.

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Section: Introductionmentioning

confidence: 99%

Precision at the Bedside: Practical Efficacy of Clockwise Catheter Torque for Accurate Tip Positioning of Peripherally Inserted Central Catheters

Akatsuka,

Sugiyama

2023

Cureus

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“… 40 41 42 More specifically, there have been retrospective analyses of PICC procedures performed by well-trained nurse practitioners, 43 safety studies of PICC in patients with burns, trauma, and chemotherapy, 44 45 46 47 48 and outcomes analyses of PICC performed at the bedside in critically ill patients who cannot be transported to an interventional radiology suite. 49 50 Other studies have devised formulas to optimize catheterization length and tip placement using patient height, weight, and ultrasound-determined anatomical features. 51 52 …”

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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Establishment of a risk prediction model for peripherally inserted central catheter‐related bloodstream infections based on a systematic review and meta‐analysis of 20 cohorts

Zhang,

Li,

Chen

et al. 2024

Worldviews Ev Based Nurs

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BackgroundPeripherally inserted central catheters (PICCs) are commonly used for extended intravenous therapy but are associated with a significant risk of bloodstream infections (BSIs), which increase morbidity and healthcare costs.AimThe aim of this study was to identify patients at high risk of developing PICC‐related bloodstream infections (PICC‐RBSIs) to establish new and more specific targets for precise prevention and intervention.MethodsA search was conducted from the earliest available record to May 2024 among the following databases: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus, and Chinese National Knowledge Infrastructure (CNKI). Hand searching for gray literature and reference lists of included papers was also performed. We assessed the quality of the studies using the Newcastle–Ottawa Scale (NOS) checklist. Two reviewers screened all the retrieved articles, extracted the data, and critically appraised the studies. Data analysis was performed using RevMan statistical software.ResultsA total of 20 cohort studies involving 51,907 individuals were included in the analysis. The statistically significant risk factors identified were hospital length of stay, line type (tunneled), history of PICC placement, multiple lumens, previous infections, chemotherapy, total parenteral nutrition, hematological cancers, delays in catheter care, local signs of infection (e.g., localized rashes), previous BSIs, and diabetes mellitus. Due to high heterogeneity among studies regarding previous BSIs, this factor was excluded from the final predictive model, while all other risk factors were included.ConclusionsThe present meta‐analysis identified risk factors for PICC‐RBSIs and developed a predictive model based on these findings, incorporating 10 risk factors that integrate both patient‐specific and procedural factors.Linking Evidence to ActionIntegrating the risk prediction model for PICC‐RBSI into clinical guidelines and training is essential. Healthcare providers should be trained to use this model to identify high‐risk patients and implement preventive measures proactively. This integration could enhance personalized care, reduce infection incidence, and improve patient outcomes. Future research should update the model with new risk factors and validate its effectiveness in diverse clinical settings.

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Safety and Efficacy of Peripherally Inserted Central Catheter Placement by Surgical Intensivist–Led Vascular Access Team

Abstract: 2022) 38:41 15 to 20-cm CVC is implanted in the internal jugular vein (IJV), subclavian vein, or femoral vein. However, peripherally inserted central catheter (PICC) placement has been extensively adopted because it can be used for a long period

Cited by 5 publications

References 17 publications

Precision at the Bedside: Practical Efficacy of Clockwise Catheter Torque for Accurate Tip Positioning of Peripherally Inserted Central Catheters

Precision at the Bedside: Practical Efficacy of Clockwise Catheter Torque for Accurate Tip Positioning of Peripherally Inserted Central Catheters

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

Establishment of a risk prediction model for peripherally inserted central catheter‐related bloodstream infections based on a systematic review and meta‐analysis of 20 cohorts

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