Objective. To investigate the related factors of skin damage caused by peripherally inserted central catheter (PICC) in cancer patients. Methods. It was a retrospective analysis of 202 cancer patients admitted to our hospital from February 2014 to July 2019. 50 cases of PICC-related skin damage and 152 cases of non-skin damage were studied. In addition, multivariate logistic regression analysis was used to determine independent risk factors for PICC-related skin damage, including cancer patients with catheter-related skin damage and patients without skin damage. Results. 50 patients with PICC skin damage (19 males and 31 females) and 152 patients without skin damage (62 males and 90 females) were retrospectively analyzed. The skin damage rate was 24.8%. The analysis of variance results showed that many factors are related to PICC catheter-related skin damage, including hormones (χ2/Z = 4.468, P < 0.05 ), body mass index (BMI) (χ2/Z = −2.443, P < 0.05 ), days with tube (χ2 = 26.230, P < 0.05 ), chemotherapy cycle (χ2/Z = 25.638, P < 0.05 ), and self-care ability (χ2/Z = −1.968, P < 0.05 ). Logistic regression analysis showed that hormones (odds ratio (OR) = 3.896, P = 0.045 ), BMI (OR = 1.129, P = 0.017 ), days with tube (OR = 0.419, P = 0.013 ), and chemotherapy cycle (OR = 3.302, P = 0.028 ) are independent factors affecting PICC-related skin damage. Conclusion. The independent influencing factors of skin damage during PICC catheterization are hormones, BMI, number of days with tube, and chemotherapy cycle.
Purpose To explore the application of ECG‐guided localization technology in PICC catheterization and the clinical significance of different maps of intracavitary ECG in PICC tip localization. Methods In the process of catheter placement under the guidance of ultrasound, the technique of intracavitary ECG location was used. The length of the catheter was measured on the body's surface. The amplitude of the P‐wave and the QRS‐wave groups of electrocardiograms before and during catheter placement was recorded. Nine hundred sixty‐one patients who underwent X‐ray chest film examination after catheterization were imaged on the chest film at the tip of the catheter. Results Eight hundred four cases had a characteristic P wave, 83.66%, of which, 331 cases (50% < P/R ≤80%) had 99.09%; 425 cases (80% < P/R ≤100%) had 99.29%; 48 cases (P/R >100%) had 100%. One hundred eighteen cases of non‐specific P wave accounted for 12.28% and 79.66% of chest radiographs, of which 72 cases of P/R <50% were 100%; 46 cases of unchanged P wave were 47.83%; 34 cases of special cases accounted for 3.54% and 55.88% of chest radiographs; five cases of interference wave accounted for 0.25%, and the chest radiographs were self‐control. The in‐place rate of the body contrast catheter was 80%. Conclusions The accuracy of the ECG characteristic map in guiding the location of the PICC tip is higher than that of the non‐characteristic P wave, and it has more clinical significance in locating the best position of the PICC tip.
Objective: Few studies have been conducted on whether catheterisation via the lower limb pathway is suitable for intracavitary electrocardiogram (ECG) technology. This study explored the positioning of the epicutaneo–caval catheter (ECC) tip with intracavitary ECG via the lower limbs in newborns to determine its optimal placement and to improve the success rate of ECC placement using this method. Methods: Twenty-eight cases were selected for the observation group. The tip location with intracavitary ECG method was used to observe the changes in specific atrial depolarisation (P-wave) during the catheterisation process to determine whether the catheter tip was in the correct position. For comparative observation, chest X-rays and abdominal radiographs were taken within 24 h to determine sensitivity and specificity. The control group included 28 cases where the ECCs were inserted via the lower limbs, and chest X-rays and abdominal radiographs were taken within 24 h after the line was placed to confirm the correct positioning. Results: The success rate of the observation group was 91.30% (there were two cases of primary malposition), and the success rate of the control group was 78.57% (there were six cases of primary malposition). The success rate of the observation group was higher compared with the control group. Conclusion: The tip location with intracavitary ECG method improved the success rate of ECC placement via the lower limbs in neonates. This method can effectively prevent the occurrence of lower limb primary catheter malposition and has significant clinical application value.
Background To evaluate chest computed tomography (CT) compared to intracavitary electrocardiogram (ECG) in predicting the length of peripherally inserted central catheter (PICC) placement and analyzing the accuracy of the positioning methods. Methods This study included a total number of 436 patients who underwent PICC placement. The patients enrolled were randomly divided into two groups: ECG group (n = 218, received IC-ECG) and chest CT group (n = 218, received chest CT). The tip length of the catheter in the superior vena cava, the measured length of the catheter and the actual insertion length of the catheter were observed and recorded in the two groups. Results The best catheterization rate of tip positioning and the one-time placement rate of tip positioning in ECG group were significantly higher than that in the chest CT group (all P < 0.05). The comfort level and satisfaction rate in ECG group was significantly higher than that of chest CT group (all P < 0.05). Conclusion Accurate catheterization length could be achieved by both chest CT and intracavitary electrocardiogram guidance in the process of predicting PICC placement length. However, IC-ECG guided procedure was more worthy of promotion in clinic.
Background In this study, the intracavitary electrocardiogram (ECG) P‐wave and QRS‐wave changes during femorally inserted central catheter (FICC) placement in adults were observed with the aim of reducing malposition occurrence. The observed method provides venous access in patients who have limited upper limb venous catheterization potential and require medium‐term and long‐term infusions. Methods A retrospective analysis of 34 adult patients who underwent FICC placement was conducted. After body surface measurements were taken, all patients were connected to an ECG during catheter placement, and the P‐wave and QRS‐wave changes were observed. Next, the catheter tip position was confirmed with an abdominal X‐ray, and an analysis of the changes occurring during the procedure was conducted. Results In the 34 patients included in the present study, the catheter tips were located below the diaphragm level in the inferior vena cava. Of the patients, 18 showed negative P waves, biphasic P waves, and positive high‐amplitude P waves with increasing the insertion depth. In 16 patients, no P‐wave characteristic changes were observed during catheterization, and an abdominal X‐ray confirmed that the catheter tip was positioned below the level of the first lumbar vertebra. Conclusion Negative P waves, biphasic P waves, and positive high‐amplitude P waves appeared during FICC placement in adults. Catheter withdrawal until the P wave reverted to normal indicated that a tip position close to the inferior vena cava above the diaphragm level was ideal.
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