Impact of subcutaneous tunnels on peripherally inserted catheter placement: a multicenter retrospective study

Kim, Il Jung; Shim, Dong Jae; Lee, Jae‐Hwan; Kim, Eung Tae; Byeon, Jong Hyun; Lee, Hun Jae; Cho, Soon Gu

doi:10.1007/s00330-018-5917-x

Cited by 21 publications

(40 citation statements)

References 16 publications

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“…A multicenter retrospective study suggested that subcutaneous tunneling could significantly reduce the rate of CLABSIs. 17 However, in our study, we did not record any CLABSI cases in either group: only three local infections were found in nontunneled PICCs, with no significant difference. This low incidence of infection might be related to having a research population with different severity levels of disease.…”

Section: Discussioncontrasting

confidence: 59%

“…12 It was noted that the incidence of wound oozing in the experimental group was significantly lower than that in the control group, which was similar to the previous study. 17,22 It was suggested that tunneled PICC could reduce wound oozing at the catheter exit site, and we also found that the reduction was hierarchical. This might be because the tunnel distance uses subcutaneous tissue to compress the site and prevent wound oozing.…”

Section: Discussionmentioning

confidence: 58%

“…The added time was similar to the first tunneled PICC study reported as having used a hemostat 18 but in contrast to the retrospective study reported as having used a hemostat and puncture needle. 17 Careful tunneling and fixation could explain the increase. In our study, a 14G trocar from the PICC kit was used for making the tunnel.…”

Section: Discussionmentioning

confidence: 99%

“…15 In addition, the tunnel distance between the puncture site and exit site helps to reduce the oozing of blood and the incidence of catheter-related infections and other complications. 16,17 However, only a few studies have described tunneled PICC. 15–20 The technique was first reported by Selby et al 18 for PICC placement in 2001.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 However, only a few studies have described tunneled PICC. 15–20 The technique was first reported by Selby et al 18 for PICC placement in 2001. Based on B-mode ultrasound guidance and MST, a tunnel was safely placed using a hemostat and scalpel.…”

Section: Introductionmentioning

confidence: 99%

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Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial

Dai

et al. 2019

J Vasc Access

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Purpose: To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound. Methods: A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat. Results: A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, P = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, P = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, P < 0.001), a lower incidence of medical adhesive–related skin injury (9.2% vs 25.3%, P = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, P = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, P = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months ( P < 0.05). Conclusion: Tunneled peripherally inserted central catheter may be recommended for good effectiveness.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%