Tip orientation under real-time point-of-care neck ultrasonic monitoring is advantageous in peripherally inserted central catheter procedures: a retrospective cohort study

Abstract

BackgroundWe analyzed the success and catheter tip malposition rates of peripherally inserted central catheter (PICC) placement using ultrasonic monitoring.MethodsA total of 564 patients were recruited and assigned to either the intervention or control group. In the intervention group, 282 patients underwent ultrasound-guided PICC insertion, which helped to identify the position and depth of the catheter tip. From a total of 9000 patients, 282 were selectively chosen to receive the traditional method using body surface measurements (control group). The primary endpoint was the success rate; the secondary endpoint was the catheter tip malposition rate as detected by postprocedure chest radiography.ResultsIn the intervention group, a total of 94 catheters were in a suboptimal position; 26 were too deep, 68 were too shallow, and 1 was inserted into the subclavian vein, with success and malposition rates of 66.3% and 0.4%, respectively. In the control group, 139 catheters were in a suboptimal position; 88 were too deep, 51 were too shallow, 9 were inserted into the jugular vein, and 2 were inserted into the subclavian vein, with success and malposition rates of 46.8% (P < 0.001) and 3.9% (P = 0.004), respectively. Significant differences were observed in success and malposition rates between the 2 groups.ConclusionUltrasound-guided PICC procedures achieved higher success rates and lower malposition rates.