초록접수 현황
| 19F-185 | 구연 미채택시 포럼 발표 |
Peripherally Inserted Central Catheter (PICC) Insertion in Intensive Care Unit: How to Reduce Malposition.
Up Huh, Sung Woon Chung, Chung Won Lee, Miju Bae, Seunghwan Song
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Republic of Korea
Purpose : In this study, we performed ultrasonographic examination of the internal jugular vein after PICC insertion to indirectly confirm whether catheter was present or not, and compared it with the previous confirmation of x-ray after PICC.
Methods : A retrospective review was conducted of all PICCs implemented in ICU in patient at a single institution in 2018. At our institution, all PICCs implemented in ICU were placed at the bedside and performed on the upper arm by one cardiovascular surgeon.
From January to June 2018, PICCs were inserted with the arm adducted under ultrasound guidance. We did not confirm the presence of the PICC catheter in the IJV on the same side using ultrasound at this time (procedure A). From July to December 2018, PICC were inserted with the arm abducted 90° from the patient’s body. We confirmed the presence of PICC catheter in IJV on the same side using ultrasonography (procedure B).
Results : From January 2018 to December 2018, there were 794 out of 650 ICU PICC patients. Procedure A was performed 418 cases and Procedure B was performed 376 cases. There was statistically significant less malposition in procedure B (procedure A = 5.7%, procedure B = 2.4%, p = 0.02).
Conclusion : In an environment where fluoroscopy is not available, a PICC can be inserted by performing an arm abducted 90 position and the presence of a catheter by checking the IJV on the ipsilateral side helps to place the catheter tip of the PICC at the correct position.
Methods : A retrospective review was conducted of all PICCs implemented in ICU in patient at a single institution in 2018. At our institution, all PICCs implemented in ICU were placed at the bedside and performed on the upper arm by one cardiovascular surgeon.
From January to June 2018, PICCs were inserted with the arm adducted under ultrasound guidance. We did not confirm the presence of the PICC catheter in the IJV on the same side using ultrasound at this time (procedure A). From July to December 2018, PICC were inserted with the arm abducted 90° from the patient’s body. We confirmed the presence of PICC catheter in IJV on the same side using ultrasonography (procedure B).
Results : From January 2018 to December 2018, there were 794 out of 650 ICU PICC patients. Procedure A was performed 418 cases and Procedure B was performed 376 cases. There was statistically significant less malposition in procedure B (procedure A = 5.7%, procedure B = 2.4%, p = 0.02).
Conclusion : In an environment where fluoroscopy is not available, a PICC can be inserted by performing an arm abducted 90 position and the presence of a catheter by checking the IJV on the ipsilateral side helps to place the catheter tip of the PICC at the correct position.
책임저자: Up Huh
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Republic of Korea
발표자: Up Huh, E-mail : tymfoo82@gmail.com