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

作　　者：Shuiqing Liu Shaowei Jiang Jing Ma Feng Qian Chengjin Gao 

机构地区：[1]Department of Ultrasound,The Third Affiliated Hospital of Soochow University,Changzhou,China [2]Department of Emergency,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China [3]Department of Pharmacy,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China

出　　处：《Emergency and Critical Care Medicine》2023年第2期57-63,共7页急危重症医学（英文）

基　　金：supported by the National Natural Science Foundation of China(82172138 and 81873947);Special Medical Innovation Project of Shanghai Science and Technology Committee(no.21Y11902400);Excellent Academic Leader Program of Shanghai Science and Technology Committee(21XD1402200);Key Laboratory of Emergency and Trauma(Hainan Medical University),Ministry of Education(grant KLET-202016).

摘　　要：Background:We analyzed the success and catheter tip malposition rates of peripherally inserted central catheter(PICC)placement using ultrasonic monitoring.Methods:A 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.Results:In 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.Conclusion:Ultrasound-guided PICC procedures achieved higher success rates and lower malposition rates.

关 键 词：Catheter tip depth precision Catheter tip malposition Peripherally inserted central catheter Superior vena cava Ultrasound 

分 类 号：R47[医药卫生—护理学]