BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients...BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.展开更多
BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic ch...BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic changes,which are usually detected during cardiac catheterization,cardiac pacemaker implantation,or PICC placement.However,in neonates with PLSVC,PICC placement can be challenging.Here,we report PICC placement in eight neonates with PLSVC.CASE SUMMARY This article introduces the concept of the“TIMB”bundle.After PICC implantation,we found PLSVC in all eight patients.The key points of care regarding PICC placement in neonates with PLSVC included“TIMB”,where“T”indicates a reasonable choice of the catheterization time,“I”refers to a retrospective analysis of imaging data before catheterization,“M”refers to correct measurement of the body surface length,and“B”indicates that the tip of the PICC is placed in the middle and lower 1/3 of the left superior vena cava under the guidance of B-ultrasound.CONCLUSION“TIMB”is a bundle for PICC placement in neonates,especially for those with PLSVC.Using this new approach can improve the first-attempt success rate of PICC placement,reveal cardiovascular abnormalities in advance,allow the selection of different measurement methods reasonably according to the puncture site,and finally,improve the accuracy of catheter positioning through the use of B-ultrasound guidance.展开更多
We report a case of a 7-year-old child who received a peripherally inserted central catheter (PICC) for chemotherapy. He suffered from an unusual PICC fracture in vivo with pulmonary embolism after eight circles of ch...We report a case of a 7-year-old child who received a peripherally inserted central catheter (PICC) for chemotherapy. He suffered from an unusual PICC fracture in vivo with pulmonary embolism after eight circles of chemotherapeutic agents administered. In this case report, we review the literatures for the underlying pathophysiology of this uncommon phenomenon. IV nurses should consider the possibility of the infusion dysfunction deriving from the PICC line fractured. Accurate tip catheter placement and specific care may reduce morbidity.展开更多
BACKGROUND Individuals with diabetes mellitus have a higher risk of developing malignant tumors,and diagnosing these tumors can be challenging.AIM To confirm the benefits of using peripherally inserted central cathete...BACKGROUND Individuals with diabetes mellitus have a higher risk of developing malignant tumors,and diagnosing these tumors can be challenging.AIM To confirm the benefits of using peripherally inserted central catheters(PICCs)in contrast-enhanced computerized tomography(CECT)for diagnostic imaging in diabetic patients with malignant tumors and to provide a research basis for follow-up research.METHODS This retrospective study analyzed 204 diabetic patients with malignancies treated at The Second Affiliated Hospital,Jiangxi Medical College,Nanchang University,from January 2024 to June 2024.The patients were divided into two groups:A control group(n=102)with indwelling peripheral intravenous catheters and a research group(n=102)with high-pressure-resistant PICC.The study compared baseline data,the incidence of iodine contrast extravasation during CECT,the incidence of adverse events(discomfort,redness and swelling at the puncture site,and blood oozing),imaging quality,nursing time,intubation success rate,number of venipuncture attempts,and catheter maintenance cost.RESULTS Male patients accounted for 51.96%in the control group and 55.88%in the research group;the average age was(59.68±11.82)years in the control group and(61.41±12.92)years in the research group;the proportions of lung cancer,colorectal cancer,and gastric cancer patients in the control group were 42.16%,38.24%,and 19.61%,respectively,while those in the research group were 34.31%,37.25%,and 28.43%,respectively.Except for the gender distribution,age,and cancer type mentioned above,other general information such as underlying diseases,puncture location,and long-term chemotherapy shows no significant differences as tested(P>0.05).The results showed that the research group had significantly reduced incidence of iodine contrast extravasation(7 vs 1,P=0.031),similar incidence of adverse events(11 vs 7,P=0.324),reduced nursing time[(18.50±2.68)minutes vs(13.26±3.00)minutes,P=0.000],fewer venipuncture attempts[(2.21±0.78)times vs(1.49±0.58)times,P=0.000],lower catheter maintenance cost[(1251.79±205.47)China yuan(CNY)vs(1019.25±117.28)CNY,P=0.000],increased intubation success rate(16.67%vs 58.82%,P=0.000),and better imaging quality(85.29%vs 94.12%,P=0.038).CONCLUSION High-pressure-resistant PICCs can lessen the physical burden of diabetic patients during nursing,reduce treatment costs,and improve the efficiency and quality of imaging for diagnosis malignant tumors.展开更多
Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN ch...Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.展开更多
目的探讨基于培训迁移理论的静脉治疗系统化培训在静疗护理专科联盟的应用效果。方法通过基线调查、现况分析、文献查阅及小组讨论构建基于培训迁移理论的静脉治疗系统化培训内容,选取广西静脉治疗护理专科联盟医院的71名护士,采用自身...目的探讨基于培训迁移理论的静脉治疗系统化培训在静疗护理专科联盟的应用效果。方法通过基线调查、现况分析、文献查阅及小组讨论构建基于培训迁移理论的静脉治疗系统化培训内容,选取广西静脉治疗护理专科联盟医院的71名护士,采用自身前后对照法,比较培训前和培训后1个月、3个月护士的静疗行为规范、培训迁移行为得分及经外周置入中心静脉导管(peripherally inserted central catheter,PICC)并发症发生率。结果(1)静疗行为规范:规范PICC冲封管及规范PICC拔除2项培训前后比较差异有统计学意义(P<0.05)。(2)PICC并发症发生率:从培训前的8.80%下降至培训后的7.32%,差异有统计学意义(P<0.05)。(3)培训迁移行为:培训前和培训后1个月、3个月评分差异有统计学意义(P<0.05)。结论基于培训迁移理论的静脉治疗系统化培训能规范护士的静疗行为,提高护士的培训迁移行为,提高并发症处理能力,降低PICC导管并发症的发生,系统化的理论培训较日常零散的培训效果显著,但随着时间推移其应用情况呈下降趋势,提示延续培训的必要性。展开更多
基金the Chongqing Medical Scientific Research Project(a joint project of the Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX046。
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.
基金Supported by the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission,No.18PJ215.
文摘BACKGROUND Reports on peripherally inserted central catheter(PICC)placement in neonates with persistent left superior vena cava(PLSVC)are rare.The majority of PLSVC patients have no clinical symptoms or hemodynamic changes,which are usually detected during cardiac catheterization,cardiac pacemaker implantation,or PICC placement.However,in neonates with PLSVC,PICC placement can be challenging.Here,we report PICC placement in eight neonates with PLSVC.CASE SUMMARY This article introduces the concept of the“TIMB”bundle.After PICC implantation,we found PLSVC in all eight patients.The key points of care regarding PICC placement in neonates with PLSVC included“TIMB”,where“T”indicates a reasonable choice of the catheterization time,“I”refers to a retrospective analysis of imaging data before catheterization,“M”refers to correct measurement of the body surface length,and“B”indicates that the tip of the PICC is placed in the middle and lower 1/3 of the left superior vena cava under the guidance of B-ultrasound.CONCLUSION“TIMB”is a bundle for PICC placement in neonates,especially for those with PLSVC.Using this new approach can improve the first-attempt success rate of PICC placement,reveal cardiovascular abnormalities in advance,allow the selection of different measurement methods reasonably according to the puncture site,and finally,improve the accuracy of catheter positioning through the use of B-ultrasound guidance.
文摘We report a case of a 7-year-old child who received a peripherally inserted central catheter (PICC) for chemotherapy. He suffered from an unusual PICC fracture in vivo with pulmonary embolism after eight circles of chemotherapeutic agents administered. In this case report, we review the literatures for the underlying pathophysiology of this uncommon phenomenon. IV nurses should consider the possibility of the infusion dysfunction deriving from the PICC line fractured. Accurate tip catheter placement and specific care may reduce morbidity.
基金Supported by Jiangxi Provincial Department of Education Science and Technology Research Project-Youth Project(Research on the application of high-pressure PICC catheter in abdominal CT enhancement of tumor patients),No.200242.
文摘BACKGROUND Individuals with diabetes mellitus have a higher risk of developing malignant tumors,and diagnosing these tumors can be challenging.AIM To confirm the benefits of using peripherally inserted central catheters(PICCs)in contrast-enhanced computerized tomography(CECT)for diagnostic imaging in diabetic patients with malignant tumors and to provide a research basis for follow-up research.METHODS This retrospective study analyzed 204 diabetic patients with malignancies treated at The Second Affiliated Hospital,Jiangxi Medical College,Nanchang University,from January 2024 to June 2024.The patients were divided into two groups:A control group(n=102)with indwelling peripheral intravenous catheters and a research group(n=102)with high-pressure-resistant PICC.The study compared baseline data,the incidence of iodine contrast extravasation during CECT,the incidence of adverse events(discomfort,redness and swelling at the puncture site,and blood oozing),imaging quality,nursing time,intubation success rate,number of venipuncture attempts,and catheter maintenance cost.RESULTS Male patients accounted for 51.96%in the control group and 55.88%in the research group;the average age was(59.68±11.82)years in the control group and(61.41±12.92)years in the research group;the proportions of lung cancer,colorectal cancer,and gastric cancer patients in the control group were 42.16%,38.24%,and 19.61%,respectively,while those in the research group were 34.31%,37.25%,and 28.43%,respectively.Except for the gender distribution,age,and cancer type mentioned above,other general information such as underlying diseases,puncture location,and long-term chemotherapy shows no significant differences as tested(P>0.05).The results showed that the research group had significantly reduced incidence of iodine contrast extravasation(7 vs 1,P=0.031),similar incidence of adverse events(11 vs 7,P=0.324),reduced nursing time[(18.50±2.68)minutes vs(13.26±3.00)minutes,P=0.000],fewer venipuncture attempts[(2.21±0.78)times vs(1.49±0.58)times,P=0.000],lower catheter maintenance cost[(1251.79±205.47)China yuan(CNY)vs(1019.25±117.28)CNY,P=0.000],increased intubation success rate(16.67%vs 58.82%,P=0.000),and better imaging quality(85.29%vs 94.12%,P=0.038).CONCLUSION High-pressure-resistant PICCs can lessen the physical burden of diabetic patients during nursing,reduce treatment costs,and improve the efficiency and quality of imaging for diagnosis malignant tumors.
文摘Purpose: Research on clinical application effect of combining very low birth weight newborn (VLBWN) umbilical vein catheterization (UVC) with peripherally inserted central catheter (PICC). Method: 60 cases of VLBWN checked in our hospital’s ICU are selected and divided into combination group (n = 30) and PICC group (n = 30) according to the random number table. Combination of UVC and PICC is applied on newborn of combination group while only PICC is applied on newborn of PICC group. These two groups’ newborn’s PICC catheterization operation time, PICC indwelling time, weight gain, hospital stays, hospital infection, planned extubation, successful single puncture, adverse events and other indexes are observed. Result: Newborns in combination group have less PICC catheterization operation time and less hospital stays than newborns in PICC group while newborns in combination group have longer PICC indwelling time and greater weight gain than newborns in PICC group. The difference here has statistical significance (p < 0.05). Combination group’s hospital infection ratio (3.33%) is lower than that of PICC group (23.33%). The difference here has statistical significance (p < 0.05). Newborns in combination group have a planned extubation rate of 93.33% and a successful single puncture rate of 93.33%, which are greater than those of newborn in PICC group (respectively 73.33% and 70.00%). The difference here has statistical significance (p < 0.05). Newborns in combination group have an adverse event occurrence rate of 43.33%, lower than that of PICC group (70.00%). The difference here has statistical significance (p < 0.05). Conclusion: Application of combination of UVC and PICC on VLBWN can greatly improve PICC catheterization efficiency and newborn patients’ nutriture and reduce rate of complications, thus, it is worthy of clinical application.
文摘目的探讨基于培训迁移理论的静脉治疗系统化培训在静疗护理专科联盟的应用效果。方法通过基线调查、现况分析、文献查阅及小组讨论构建基于培训迁移理论的静脉治疗系统化培训内容,选取广西静脉治疗护理专科联盟医院的71名护士,采用自身前后对照法,比较培训前和培训后1个月、3个月护士的静疗行为规范、培训迁移行为得分及经外周置入中心静脉导管(peripherally inserted central catheter,PICC)并发症发生率。结果(1)静疗行为规范:规范PICC冲封管及规范PICC拔除2项培训前后比较差异有统计学意义(P<0.05)。(2)PICC并发症发生率:从培训前的8.80%下降至培训后的7.32%,差异有统计学意义(P<0.05)。(3)培训迁移行为:培训前和培训后1个月、3个月评分差异有统计学意义(P<0.05)。结论基于培训迁移理论的静脉治疗系统化培训能规范护士的静疗行为,提高护士的培训迁移行为,提高并发症处理能力,降低PICC导管并发症的发生,系统化的理论培训较日常零散的培训效果显著,但随着时间推移其应用情况呈下降趋势,提示延续培训的必要性。
