Malposition of peripherally inserted central catheter: Experience from 3012 cancer patients

Abstract

The objectives of the study are to observe and analyze the causes of 237 patients' malposition peripherally inserted central catheter (PICC) from 3012 patients in clinical practice and to further explore the methods of its prevention and remedies, which can help to improve the skills of placing tubes, to efficiently avoid and reduce the occurrence of complications, and to alleviate the pains and cost of patients. From August 2000 to March 2012, 3012 cases receiving PICC were reviewed. The locations of the tube tips were recorded by chest X ray and summarized for analysis. Malposition was observed in 237 cases (7.87%). The most frequently occurring site was in the jugular vein followed by the axillary vein. By taking different remedies, all the malpositioned PICCs were relocated in the superior vena cava or subclavian vein. In order to secure the safety usage of PICC, the strict rules of handling, the skill and experience of operator, and cooperation patients are necessary.

Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

“…During the PICC placement procedure, the most problematic parts were venous access and catheter tip positioning. In our study, the overall venous access success rate was 98.6%, which is similar to previous reports (91%-100%) that used ultrasound guidance [16,17]. In our study, the failure rate was almost double with the blind technique (2.9%) compared to the ultrasound guidance technique (1.4%).…”

A randomized controlled study of bedside electrocardiograph-guided tip location technique & the traditional chest radiography tip location technique for peripherally inserted central venous catheter in cancer patients

“…No patient had chest discomfort, arrhythmia or infection. To secure the safety usage of PICC and reduce the PICC-related complications, the strict rules of handling, the skill and experience of operator and cooperation of patients are necessary 24 . However, at the end of three and six months, the cases with thrombogenesis were found to be significantly lower in the ECG test group.…”

Peripherally Inserted Central Venous Catheter in Upper Extremities Could be a Risk for Deep Vein Thrombosis in Lower Extremities and D-Dimer in Neurology Department

“…As a new infusion tool, PICC can reduce the pain of repeated puncture and reduce the incidence of drug extravasation, which is welcomed by clinical medical staff, patients and family members. However, PICC insertion and displacement will damage the vascular intima [2], The presence of PICC occupies part of the inner diameter of the vein [3,4], coupled with the patients' own diseases and medication induced hypercoagulable state [5], just meet the Virchow's triad [6]. The incidence of PICC related upper extremity deep venous thrombosis(UEDVT) was 51.4% − 71.9% [7][8][9].…”

“…Previous studies have suggested that PICC related venous thrombosis is mainly mural thrombus, which is mainly limited to the venous route where the catheter is located [13][14][15]. With the deepening of the study, some data show that the incidence of lower extremity deep venous thrombosis (LEDVT) in patients with PICC is higher than that of patients without PICC, and PICC related venous thrombosis seems to have exceeded the range of the venous route where the catheter is located [2] [6,[16][17][18]. How to explain this clinical phenomenon?…”