Implementation of tunneled versus not tunneled peripherally inserted central catheters

Kapritsou, Maria; Theodoros, Katsoulas; Bastaki, Maria; Kiekkas, Panagiotis; Stafylarakis, Emmanouil; Evangelos, Konstantinou A.

doi:10.1016/j.jvn.2018.11.007

Cited by 7 publications

(12 citation statements)

References 10 publications

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“…However, these previous studies were single-center clinical trials with small samples. 8,10,11 Moreover, the tunneling devices used in previous studies, such as hemostats, puncture needles, and 14G trocars, are inappropriate 5,[12][13][14] ; such devices have a limited effect on catheter fixation and may even exert more trauma to the subcutaneous tissue. Therefore, the present randomized controlled trial was performed to evaluate the impact of the subcutaneous tunneling technique using a proper metal tunneller on the outcomes of patients with PICCs.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

Xiao

et al. 2021

J Int Med Res

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Objective To compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs). Methods One hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups. Results In total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99–32.83) vs. 15.69 (10.51–57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups. Conclusions The subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.

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Section: Introductionmentioning

confidence: 99%

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

Xiao

et al. 2021

J Int Med Res

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“…The tunneling technique is currently widely used for the placement of CVCs from dialysis and long-term catheters for chemotherapy, parenteral nutrition, and drug delivery. Recently, some clinicians have used this technique for peripherally inserted central catheters 3 (PICCs), or Midline catheters 4 (MCs).…”

Section: Introductionmentioning

confidence: 99%

Tunneling technique of PICCs and Midline catheters

et al. 2021

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Background: The tunneling technique is currently widely used for placement of CVC. Recently, some clinicians have used this technique for peripherally inserted central catheters (PICC), or Midline catheters (MCs). Objective: To describe a safe antegrade tunneling technique for PICCs and MCs insertion with a blunt tunneler. Methods: This retrospective monocentric survey collected ASST Lodi hospital data from January 1st to December 31st, 2019. The indication for PICCs and MCs tunneled implant was to respect the correct vein/catheter ratio or special clinical situation (children, burns, wounds, and wider catheter 5/6 fr). Contraindications included the operator’s low skills and severe risk of bleeding (INR > 3; Platelet count <50’000). Results: About 390 PICCs (327 4 fr and 63 5 fr) and 183 MCs were placed. One hundred and sixty-five PICCs (42%) and 110 MCs (60%) were tunneled. Five fr PICCs were more present among tunneled catheters (54/165 [32.7%] vs 9/225 [4%] p < 0.0001). In the majority tunneling was necessary to respect the correct catheter/vein ratio. The exit site was shifted only for four special clinical situations: skin infections (one PICC and two MCs); burns (one MC). No early complication (intraprocedural, major bleeding), catheter related thrombosis, or device fractures occurred. Two catheter-related bloodstream infections (one PICC, one MC), nine dislocations (four PICCs, five MCs), one MC occlusion were recorded. Conclusions: The antegrade tunneling technique with blunt tunneler of PICCs and MCs is simple, rapid and is regarded as a safe maneuver. More in-depth and future prospective studies are needed to evaluate the impact of tunneling on early and late complications.

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“…Previous studies have demonstrated that tunneled PICCs have technical advantages (Elli et al, 2017; Maria et al, 2019; Subramanian et al, 2013). However, the non-randomized methodology and small sample size did not provide sufficient evidence of tunneled PICCs’ effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study

Sheng,

Yang,

et al. 2023

Clin Nurs Res

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This study sought to evaluate the impact of the subcutaneous tunneling technique on peripherally inserted central catheter (PICC) placement. We randomized 694 patients who needed PICC placement to either the tunneled PICCs (experimental group) or the non-tunneled PICCs (control group) from August to December 2021. The cumulative frequency of complications was assessed as the primary outcome. Secondary outcomes comprised the amount of bleeding, catheter insertion time, self-reported pain score, and one-puncture success rate. After 6 months of follow-up, the tunneled PICCs significantly decreased the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased. This randomized multicenter study supports the efficacy of subcutaneous tunneling technology in reducing PICC-related complications, enhancing patient comfort, and encouraging using subcutaneous tunneling technology for PICC placement.

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Implementation of tunneled versus not tunneled peripherally inserted central catheters

Cited by 7 publications

References 10 publications

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

Tunneling technique of PICCs and Midline catheters

Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study

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