EVALUATION STUDY
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Add like
Add dislike
Add to saved papers

Analysis of tip malposition and correction in peripherally inserted central catheters placed at bedside by a dedicated nursing team.

PURPOSE: To analyze the patterns of postplacement tip malposition in peripherally inserted central catheters (PICCs) placed at bedside, and to describe results of bedside and imaging-guided correction of tip malposition.

MATERIALS AND METHODS: With use of a quality assurance database, all episodes of tip malposition in PICCs placed at bedside were reviewed. Catheter tip location, success or failure of bedside repositioning (in a subset of patients, by using over-the-wire techniques), findings in the interventional radiology (IR) division, and tip correction method used in the IR suite (repositioning vs replacement) were determined with a review of medical records.

RESULTS: During the 18-month study period, 2,367 attempts were made to place a PICC at bedside; 1,654 attempts (70%) were initially successful. Of these, 163 tips (10%) were malpositioned. Complete records for 132 malpositioned tips were available for analysis. Malpositioned tips were located in the ipsilateral internal jugular vein in 45 of the 132 cases (36%), axillary vein in 36 cases (27%), ipsilateral subclavian vein in 25 cases (19%), ipsilateral brachiocephalic vein in 15 cases (11%), contralateral subclavian vein in four cases (3%), contralateral brachiocephalic vein in two cases (2%), contralateral internal jugular vein in one case (1%), and subclavian tributary in one case (1%). In three cases (2%), the tip was coiled in the superior vena cava. Malposition was corrected with catheter exchange in 76 of the 132 cases (58%), repositioning in 48 cases (36%), or removal in one case (1%). Spontaneous correction occurred in seven of the 132 malpositioned tips (5%). One hundred nine tips (83%) were repositioned in the IR division with use of imaging guidance, with 100% success. Twenty-five attempts were made to correct malposition at bedside; 16 of those attempts (64%) were successful.

CONCLUSION: Tip malposition is relatively frequent with bedside placement of PICCs. Preliminary data suggest that most malpositions can be corrected with bedside techniques. Spontaneous correction may occur but is relatively uncommon.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app