Effect Evaluation of Blinding Manipulation of Peripherally-inserted Central Catheter by Using the Carina as Evaluation Mark_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHANGXiao-xia ¹ ^# ,  ZHANGYang-guang ² ^# , YUHua-qin ¹ , LIUJuan ¹ , JIAYi ¹ ,  LIUChang ³

1. Tumour Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Urinary Surgery, Third People's Hospital of Guangyuan, Guangyuan 628001, China;
3. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUChang, Email: zxtcwchscu@163.com

Keywords：

Peripherally-inserted central catheter; Adult patient; Carina; Central venous; Catheter tip location

DOI：

10.7507/1672-2531.20150023

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Objective To evaluate tip location of peripherally inserted central catheter (PICC) by using the carina as evaluation mark, so as to provide clinical references for blinding manipulation of PICC. Methods A retrospective analysis about the effects of tip location of PICC by using the carina as evaluation mark on inpatients with malignant tumour was conducted in tumour centre of the West China Hospital from March 2013 to April 2014. Chest X radiography was applied to evaluate the tip location of PICC. Statistical analysis was performed using SPSS software (version 19.0) and the outcomes were presented by frequency and percentage. Results A total of 612 cases of blinding manipulation of PICC were evaluated, of which, 502 (82%) were located in the central venous and 110 (18%) were located in the noncentral venous. The numbers of those with the catheter tips located in the non-central venous were 38 in the right atrium, 33 in the internal jugular vein, 24 in the innominate vein, 8 in the axillary vein, and 7 in the subclavian vein, respectively. Conclusion The effects of blinding manipulation of peripherally-inserted central catheter by using the carina as evaluation mark are relatively good. But it still needs to be improved.

Citation： ZHANGXiao-xia, ZHANGYang-guang, YUHua-qin, LIUJuan, JIAYi, LIUChang. Effect Evaluation of Blinding Manipulation of Peripherally-inserted Central Catheter by Using the Carina as Evaluation Mark. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 130-132. doi: 10.7507/1672-2531.20150023 Copy

1.	Safdar N, Maki DG. Risk of catheter-related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest, 2005, 128(2):489-495.
2.	DeChicco R, Seidner DL, Brun C, et al. Tip position of long-term central venous access devices used for parenteral nutrition. JPEN J Parenter Enteral Nutr, 2007, 31(5):382-387.
3.	Stone PA, Hass SM, Knackstedt KS, et al. Malposition of a central venous catheter into the right internal mammary vein:a review of complications of catheter misplacement. Vasc Endovascular Surg, 2012, 46(2):187-189.
4.	Colomina MJ, Godet C, Pellisé F, et al. Cardiac tapenade associated with a peripheral vein central venous catheter. Paediatr Anaesth, 2005, 15(11):988-992.
5.	Kunizawa A, Fujioka M, Mink S, et al. Central venous catheterinduced delayed hydrothorax via progressive erosion of central venous wall. Minerva Anestesiol, 2010, 76(10):868-871.
6.	Kim MH, Lee DJ, Kim MC. Bilateral hydrothorax and cardiac tamponade after right subclavian vein catheterization-a case report. Korean J Anesthesiol, 2010, 59(Suppl):S211-217.
7.	Burns KE, McLaren A. Catheter-related right atrial thrombus and pulmonary embolism:a case report and systematic review of the literature. Can Respir J, 2009, 16(5):163-165.
8.	Racadio JM, Doellman DA, Johnson ND, et al. Pediatric peripherally inserted central catheters:complication rates related to catheter tip location. Pediatrics, 2001, 107(2):E28.
9.	Schuster M, Nave H, Piepenbrock S, et al. The carina as a landmark in central venous catheter placement. Br J Anaesth, 2000, 85(2):192-194.
10.	Albrecht K, Nave H, Breitmeier D, et al. Applied anatomy of the superior vena cava-the carina as a landmark to guide central venous catheter placement. Br J Anaesth, 2004, 92(1):75-77.
11.	贾怡, 刘琼芳, 张晓霞, 等. 以气管隆突为标识的PICC尖端定位研究. 护士进修杂志, 2014, 29(16):1514-1516.
12.	Tian G, Chen B, Qi L, et al. Modified insertion of a peripherally inserted central catheter:taking the chest radiograph earlier. Crit Care Nurse, 2011, 31(2):64-69.
13.	Vesely TM. Central venous catheter tip position:a continuing controversy. J Vasc Interv Radiol, 2003, 14(5):527-534.
14.	Venkatesan T, Sen N, Korula PJ, et al. Blind placements of peripherally inserted antecubital central catheters:initial catheter tip position in relation to carina. Br J Anaesth, 2007, 98(1):83-88.
15.	National Kidney Foundation. K/DOQI clinical practice guidelines for vascular access. Am J Kidney Dis, 2001, 37(suppl 1):S137-181.
16.	Tan PL, Gibson M. Central venous catheters:the role of radiology. Clin Radiol, 2006, 61(1):13-22.
17.	Trerotola SO, Thompson S, Chittams J, et al. Analysis of tip malposition and correction in peripherally inserted central catheters placed at bedside by a dedicated nursing team. J Vasc Interv Radiol, 2007, 18(4):513-518.
18.	Hostetter N, Nakasawa N, Tompkins K, et al. Precision in central venous catheter tip placement:a review of the literature. Journal of the Association for Vascular Access, 2010, 15(3):112-113, 115-116, 118-119, 121-122, 124-125.
19.	Harako ME, Nguyen TH, Cohen AJ. Optimizing the patient positioning for PICC line tip determination. Emerg Radiol, 2004, 10(4):186-189.
20.	Kim MC, Kim KS, Choi YK, et al. An estimation of right- and leftsided central venous catheter insertion depth using measurement of surface landmarks along the course of central veins. Anesth Analg, 2011, 112(6):1371-1374.
21.	Joshi S, Kulkarni A, Bhargava AK. Evaluation of length of central venous catheter inserted via cubical route in Indian patient. Indian J Crit Care Med, 2010, 14(4):180-184.
22.	Fricke BL, Racadio JM, Duckworth T, et al. Placement of peripherally inserted central catheters without fluoroscopy in children:initial catheter tip position. Radiology, 2005, 234(3):887-892.

1. Safdar N, Maki DG. Risk of catheter-related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest, 2005, 128(2):489-495.
2. DeChicco R, Seidner DL, Brun C, et al. Tip position of long-term central venous access devices used for parenteral nutrition. JPEN J Parenter Enteral Nutr, 2007, 31(5):382-387.
3. Stone PA, Hass SM, Knackstedt KS, et al. Malposition of a central venous catheter into the right internal mammary vein:a review of complications of catheter misplacement. Vasc Endovascular Surg, 2012, 46(2):187-189.
4. Colomina MJ, Godet C, Pellisé F, et al. Cardiac tapenade associated with a peripheral vein central venous catheter. Paediatr Anaesth, 2005, 15(11):988-992.
5. Kunizawa A, Fujioka M, Mink S, et al. Central venous catheterinduced delayed hydrothorax via progressive erosion of central venous wall. Minerva Anestesiol, 2010, 76(10):868-871.
6. Kim MH, Lee DJ, Kim MC. Bilateral hydrothorax and cardiac tamponade after right subclavian vein catheterization-a case report. Korean J Anesthesiol, 2010, 59(Suppl):S211-217.
7. Burns KE, McLaren A. Catheter-related right atrial thrombus and pulmonary embolism:a case report and systematic review of the literature. Can Respir J, 2009, 16(5):163-165.
8. Racadio JM, Doellman DA, Johnson ND, et al. Pediatric peripherally inserted central catheters:complication rates related to catheter tip location. Pediatrics, 2001, 107(2):E28.
9. Schuster M, Nave H, Piepenbrock S, et al. The carina as a landmark in central venous catheter placement. Br J Anaesth, 2000, 85(2):192-194.
10. Albrecht K, Nave H, Breitmeier D, et al. Applied anatomy of the superior vena cava-the carina as a landmark to guide central venous catheter placement. Br J Anaesth, 2004, 92(1):75-77.
11. 贾怡, 刘琼芳, 张晓霞, 等. 以气管隆突为标识的PICC尖端定位研究. 护士进修杂志, 2014, 29(16):1514-1516.
12. Tian G, Chen B, Qi L, et al. Modified insertion of a peripherally inserted central catheter:taking the chest radiograph earlier. Crit Care Nurse, 2011, 31(2):64-69.
13. Vesely TM. Central venous catheter tip position:a continuing controversy. J Vasc Interv Radiol, 2003, 14(5):527-534.
14. Venkatesan T, Sen N, Korula PJ, et al. Blind placements of peripherally inserted antecubital central catheters:initial catheter tip position in relation to carina. Br J Anaesth, 2007, 98(1):83-88.
15. National Kidney Foundation. K/DOQI clinical practice guidelines for vascular access. Am J Kidney Dis, 2001, 37(suppl 1):S137-181.
16. Tan PL, Gibson M. Central venous catheters:the role of radiology. Clin Radiol, 2006, 61(1):13-22.
17. Trerotola SO, Thompson S, Chittams J, et al. Analysis of tip malposition and correction in peripherally inserted central catheters placed at bedside by a dedicated nursing team. J Vasc Interv Radiol, 2007, 18(4):513-518.
18. Hostetter N, Nakasawa N, Tompkins K, et al. Precision in central venous catheter tip placement:a review of the literature. Journal of the Association for Vascular Access, 2010, 15(3):112-113, 115-116, 118-119, 121-122, 124-125.
19. Harako ME, Nguyen TH, Cohen AJ. Optimizing the patient positioning for PICC line tip determination. Emerg Radiol, 2004, 10(4):186-189.
20. Kim MC, Kim KS, Choi YK, et al. An estimation of right- and leftsided central venous catheter insertion depth using measurement of surface landmarks along the course of central veins. Anesth Analg, 2011, 112(6):1371-1374.
21. Joshi S, Kulkarni A, Bhargava AK. Evaluation of length of central venous catheter inserted via cubical route in Indian patient. Indian J Crit Care Med, 2010, 14(4):180-184.
22. Fricke BL, Racadio JM, Duckworth T, et al. Placement of peripherally inserted central catheters without fluoroscopy in children:initial catheter tip position. Radiology, 2005, 234(3):887-892.

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Effect Evaluation of Blinding Manipulation of Peripherally-inserted Central Catheter by Using the Carina as Evaluation Mark

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