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...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.展开更多
Objective To invesigate the rational of deciding the intubation depth of central venous catheterization based on Intra-atria Cardiogram.Methods Patients who underwent cardiac surgery with CPB were enrolled in this stu...Objective To invesigate the rational of deciding the intubation depth of central venous catheterization based on Intra-atria Cardiogram.Methods Patients who underwent cardiac surgery with CPB were enrolled in this study.Intra-atria Cardiogram guided group included 200 patients,and routine catheterization group included 200 patients.In the observed group,as the guide wire and the catheter entered the vein,the outside tip of the guide wire was connected to an electrocardiographic unit and the intracardiac electrocardiography obtained from J-tip of the guide wire coude be observed.During operation,the tip position was observed,and after operation routine X-ray plain film examination was conducted.Results Total successful location rate increased from 58% to 91.7%,adult patients from 80% to 92.6%,wkile pediatric patients increased from 33.7% to 90.7%.Conclusions Intra-atria cardiogram based central venous catheterizatioh can increase the successful location rate and is a practical and reliable technique to ensure the placement of the catheter electrocardiography.Especially suit for pediatric patient.展开更多
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)+1 种基金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).
文摘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.
文摘Objective To invesigate the rational of deciding the intubation depth of central venous catheterization based on Intra-atria Cardiogram.Methods Patients who underwent cardiac surgery with CPB were enrolled in this study.Intra-atria Cardiogram guided group included 200 patients,and routine catheterization group included 200 patients.In the observed group,as the guide wire and the catheter entered the vein,the outside tip of the guide wire was connected to an electrocardiographic unit and the intracardiac electrocardiography obtained from J-tip of the guide wire coude be observed.During operation,the tip position was observed,and after operation routine X-ray plain film examination was conducted.Results Total successful location rate increased from 58% to 91.7%,adult patients from 80% to 92.6%,wkile pediatric patients increased from 33.7% to 90.7%.Conclusions Intra-atria cardiogram based central venous catheterizatioh can increase the successful location rate and is a practical and reliable technique to ensure the placement of the catheter electrocardiography.Especially suit for pediatric patient.
