The “Off-Label” Use of PICCs

Pittiruti, Mauro

doi:10.1007/978-88-470-5665-7_12

Cited by 26 publications

(17 citation statements)

References 11 publications

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“…Without Dacron cuffs, we consider that this might be related to the pressure of subcutaneous tunnel tissue. Similar to previous studies, 20,31 subcutaneous tunnel positioning could fix the catheter well and reduce catheter dislodgement. Catheter dislodgement can be caused by coughing, vomiting, improper arm position, or skin problems.…”

Section: Discussionsupporting

confidence: 79%

“…The intervention of the tunneled technique was based on the principles of established guidelines 23 and a collaborative review of the tunnel literature. 15,16,20,24 First, we used a B-mode ultrasound device to assess the veins and the catheter exit site in the same manner as the control group and then marked the catheter exit site and the puncture site (3 cm above) in the upper arm. Second, a guide wire and a skin incision were placed at the puncture site using MST.…”

Section: Methodsmentioning

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: Discussionsupporting

confidence: 79%

Section: Methodsmentioning

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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“…We measured the best anterior-posterior diameter of each vein, avoiding exerting any excessive pressure with the probe. The veins in the arm and supra-/infraclavicular area were evaluated utilizing a modified version of 2 systematic ultrasound approaches already described in adult patients, i.e., rapid peripheral vascular assessment (RaPeVA) [18, 19] and rapid central vascular assessment (RaCeVA) [8, 19]. …”

Section: Methodsmentioning

confidence: 99%

A Systematic Ultrasound Evaluation of the Diameter of Deep Veins in the Newborn: Results and Implications for Clinical Practice

et al. 2019

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Background: In adults and children, current guidelines recommend measuring the diameter of the vein before the insertion of central catheters, in order to match vein diameter with catheter caliber and thus reduce the risk of venous thrombosis. In the neonatal intensive care unit, central catheters are often used but the vein diameter is usually not considered. Method: We assessed the diameter of the most relevant deep veins in 100 newborns, using a strict protocol of ultrasound evaluation. Results: Mean gestational age of studied infants was 32 weeks and mean weight was 1,690 g. The mean diameter of the brachiocephalic vein was consistently ≥3 mm, with no significant difference between the right and the left side. The femoral vein diameter, on the other hand, was considerably smaller than 3 mm for infants with a weight < 2,000 g. Interobserver repeatability was found to be very high. Conclusion: Preprocedural ultrasound scan of veins is feasible and easy, also in newborns, and it should be recommended for optimizing central venous catheterization.

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“…In addition, only few studies have described tunneled PICCs. 8,9 Unfortunately, the PICC kit used in this study is not commercially available outside of Japan. However, a 20G peripheral venous catheter and a 0.32-mm, 150-cm guidewire can easily substitute the components of the kit for performing the tunneling technique.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of axillary vein puncture involving peripherally inserted central venous catheters for a small basilic vein

et al. 2018

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The “Off-Label” Use of PICCs

Cited by 26 publications

References 11 publications

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

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

A Systematic Ultrasound Evaluation of the Diameter of Deep Veins in the Newborn: Results and Implications for Clinical Practice

A novel technique of axillary vein puncture involving peripherally inserted central venous catheters for a small basilic vein

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