Appropriateness of Replacing Fluoroscopic Guidance With ECG-Electromagnetic Guidance for PICC Insertion: A Randomized Controlled Trial

Gullo, Giuseppe; Colin, Anaïs; Frossard, Pierre; Jouannic, Anne Marie; Knebel, Jean-François; Qanadli, Salah D.

doi:10.2214/ajr.20.23345

Cited by 11 publications

(14 citation statements)

References 50 publications

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“…Undesirable positioning of a PICC can be associated with complications such as arrhythmias, thrombosis, phlebitis, and cardiac tamponade (9)(10)(11). Currently, various techniques for optimal positioning of a PICC have been published, including fluoroscopy-guided, magnetic tracking, electrocardiogram-based, and blind www.traumaimpro.org (1,12). Although fluoroscopy-guided insertion is considered the gold standard, the blind technique with no guidance is the most popular in the intensive care unit because it can be used at the bedside with no special technology.…”

Section: Discussionmentioning

confidence: 99%

Bedside peripherally inserted central catheter placement: focus on the procedure

Kim¹

2022

Trauma Image Proced

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A peripherally inserted central catheter (PICC) provides long-term central venous access through a peripheral vein in an upper extremity. A trained physician should insert a PICC, but any trained medical professional, such as a specially trained nurse, can perform an insertion. Appropriate PICC placement reduces complications, such as malposition and malfunction of the catheter, venous thrombosis, and infections, and overall catheter performance is better. Complications depend mainly on the adequacy of venous puncture or the positioning of the catheter tip. Better PICC performance depends on learning accurate techniques for insertion. Here, the overall procedure for bedside ultrasonography-guided PICC placement, including patient positioning, catheter preparation, venous assessment and measurement, overall technique, and catheter tip positioning, is described.

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Section: Discussionmentioning

confidence: 99%

Bedside peripherally inserted central catheter placement: focus on the procedure

Kim¹

2022

Trauma Image Proced

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“…Fluoroscopy-guided insertion uses x-ray fluoroscopy and is considered the gold standard (1)(2)(3). By design, this technique needs dedicated infrastructure and technology.…”

Section: Introductionmentioning

confidence: 99%

ECG-Based Techniques to Optimize Peripherally Inserted Central Catheters: Rationale for Tip Positioning and Practical Use

Gullo

Qanadli

2022

Front. Cardiovasc. Med.

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Intracavitary electrocardiography is an accurate guidance technique for peripherally inserted central catheters (PICC) tip location that is spreading widely among providers using non x-ray-based facilities. The principle behind this technology relies on the transmission of the electrocardiographic signal at the tip of the catheter and its use as an internal mobile electrode, allowing the system to identify the cavo-atrial junction (CAJ) through internal P-wave amplitude modulations. The gain in popularity of intracavitary electrography and its large diffusion have led manufacturers to offer various devices with heterogeneous properties, among which clinician who place PICCs have to choose. It is therefore important to understand differences between available techniques and devices. The potential impact might not only affect availability and costs but also the clinical impact through advantages and limitations regarding electric signal transmission PICC selection. Current perspectives on intracavitary electrocardiography will also be discussed, to give the reader a global view of the management of electrocardiographically guided PICCs, especially in an environment without x-ray support.

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“…Indications for percutaneous interventions are many and varied; typical examples include treatments for venous disorders [ 1 ], aneurysms [ 2 ], and peripheral and visceral arterial diseases [ 3 ]. Interventions whose sole purpose is to gain vascular access, such as for peripherally inserted central catheters, are performed exclusively under local anesthesia [ 4 ]. Furthermore, outpatient procedures have been developed and expanded during the last decade [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Virtually Augmented Self-Hypnosis applied to endovascular interventions (VA-HYPO): Randomized Controlled Trial Protocol

et al. 2022

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Endovascular interventions (EVI) are increasingly performed as minimally-invasive alternatives to surgery and have many advantages, including a decreased need for general anesthesia. However, EVI can be stressful for patients and often lead to anxiety and pain related to the procedure. The use of local anesthetics, anxiolytics, and analgesic drugs can help avoid general anesthesia. Nevertheless, these drugs have potential side effects. Alternative nonpharmacological therapies can improve patients’ experience during conscious interventions and reduce the need for additional medications. The added value of virtually augmented self-hypnosis (VA-HYPO) and its potential to reduce pain and anxiety during peripheral and visceral arterial and venous EVI is unknown. This is a prospective two-arm trial designed to randomize 100 patients in two groups according to the use or not of VA-HYPO during peripheral EVI as a complementary nonpharmacological technique to improve patient comfort. The main objective is to compare per-procedural anxiety, and the secondary aim is to compare the rated per-procedural pain in both groups. The potential significance is that VA-HYPO may improve patients’ experience during peripheral and visceral arterial and venous EVI and other minimally invasive interventions performed under local anesthesia. Trial registration: Our study is registered on clinicaltrials.gov, with trial registration number: NCT04561596.

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Appropriateness of Replacing Fluoroscopic Guidance With ECG-Electromagnetic Guidance for PICC Insertion: A Randomized Controlled Trial

Cited by 11 publications

References 50 publications

Bedside peripherally inserted central catheter placement: focus on the procedure

Bedside peripherally inserted central catheter placement: focus on the procedure

ECG-Based Techniques to Optimize Peripherally Inserted Central Catheters: Rationale for Tip Positioning and Practical Use

Virtually Augmented Self-Hypnosis applied to endovascular interventions (VA-HYPO): Randomized Controlled Trial Protocol

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