Tip malposition of peripherally inserted central catheters: a prospective randomized controlled trial to compare bedside insertion to fluoroscopically guided placement View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-12-12

AUTHORS

Frédéric Glauser, Stephane Breault, Fabio Rigamonti, Charalampos Sotiriadis, Anne-Marie Jouannic, Salah D. Qanadli

ABSTRACT

ObjectivePeripherally inserted central catheter (PICC) use continues to increase, leading to the development of a blind bedside technique (BST) for placement. The aim of our study was to compare the BST with the fluoroscopically guided technique (FGT), with specific regard to catheter tip position (CTP).Materials and methodsOne hundred eighty patients were randomized to either the BST or the FGT. All procedures were done by the same interventional team and included postprocedural chest X-ray to assess CTP. Depending on the international guidelines for optimal CTP, patients were classified in three types: optimal, suboptimal not needing repositioning, and nonoptimal requiring additional repositioning procedures. Fisher’s test was used for comparisons.ResultsOne hundred seventy-one PICCs were successful inserted. In the BST groups, 23.3% of placements were suboptimal and 30% nonoptimal, requiring repositioning. In the FGT group, 5.6% were suboptimal and 1.1% nonoptimal. Thus, suboptimal and nonoptimal CTP were significantly lower in the FGT group (p < 0.001).ConclusionTip malposition rates are high when using blind BST, exposing the patient to an increased risk of deep venous thrombosis and catheter malfunction. Using the FGT or emerging technologies that could help tip positioning are recommended, especially for long-term indications.Key points• Bedside and fluoroscopy guided techniques are commonly used for PICC placement.• Catheter malposition is the major technical issue with the bedside technique.• Catheter malposition occurred in 53% of patients with the bedside technique. More... »

PAGES

2843-2849

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-016-4666-y

DOI

http://dx.doi.org/10.1007/s00330-016-4666-y

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https://app.dimensions.ai/details/publication/pub.1045910771

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27957644


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