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首页> 外文期刊>Acute and critical care. >Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution
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Outcomes of bedside peripherally inserted central catheter placement: a retrospective study at a single institution

机译：床侧外围插管的中央导管展示率的结果：单一机构的回顾性研究

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BACKGROUND:Bedside insertion of peripherally inserted central catheters (PICCs) has higher rates of malposition than fluoroscopic-guided PICC placement. This study evaluated the success rate of bedside PICC placement, variations in tip location, and risk factors for malposition.METHODS:This retrospective study included patients who underwent bedside PICC placement from January 2013 to September 2014 in a single institution. The procedure was conducted under ultrasound guidance or by a blind method. After PICC placement, tip location was determined by chest X-ray.RESULTS:The overall venous access success rate with bedside PICC placement was 98.1% (1,302/ 1,327). There was no significant difference in the venous access success rate between ultrasound-guided placement (868/880, 98.6%) and a blind approach placement (434/447, 97.1%). Optimal tip position was achieved on the first attempt in 1,192 cases (91.6%). Repositioning was attempted in 65 patients; 60 PICCs were repositioned at the bedside, two PICCs were repositioned under fluoroscopic guidance, and three PICCs moved to the desired position without intervention. Final optimal tip position after repositioning was achieved in 1,229 (94.4%). In logistic regression analysis, five factors associated with tip malposition included female sex (Exp(B), 1.687; 95% confidence interval [CI], 1.180 to 2.412; P=0.004), older age (Exp(B), 1.026; 95% CI, 1.012 to 1.039; P0.001), cancer (Exp(B), 0.650; 95% CI, 0.455 to 0.929; P=0.018), lung disease (Exp(B), 2.416; 95% CI, 1.592 to 3.666; P0.001), and previous catheter insertions (Exp(B), 1.262; 95% CI, 1.126 to 1.414; P0.001).CONCLUSIONS:Bedside PICC placement without fluoroscopy is effective and safe in central venous catheters. Potential risk factors associated with catheter tip malposition include older age, female sex, cancer, pulmonary disease, and previous central vein catheterizations.
机译：背景：外围插入的中央导管（PICCS）的床边插入比荧光透视引导的PICC放置更高的母体位置。本研究评估了床边PICC放置的成功率，尖端位置的变化，以及孕口的危险因素。方法包括从2013年1月至2014年9月在一家机构中接受床边PICC安置的患者。该程序在超声引导下或通过盲方法进行。 PICC放置后，尖端位置由胸部X射线决定：结果：床头柜的总静脉接入成功率为98.1％（1,302 / 1,327）。超声引导展示位置（868/880,98.6％）和盲方法放置（434/447,97.1％）之间没有显着差异。最佳的尖端位置是在1,192例中的第一次尝试（91.6％）。在65名患者中尝试重新定位;在床边重新定位60 PICC，在荧光透视引导下重新定位两条PICC，并且在没有干预的情况下，三个PICC移动到所需位置。重新定位后的最终最佳尖端位置在1,229（94.4％）中实现。在Logistic回归分析中，与尖端孕口相关的五个因素包括女性（EXP（B），1.687; 95％置信区间[CI]，1.180至2.412; P = 0.004），年龄（Exp（B），1.026; 95 ％CI，1.012至1.039; p <0.001），癌症（exp（b），0.650; 95％ci，0.455至0.929; p = 0.018），肺病（exp（b），2.416; 95％ci，1.592。 3.666; p <0.001）和先前的导管插入（Exp（b），1.262; 95％ci，1.126至1.414; p <0.001）。结论：在没有荧光检查的情况下，床头隐形放置在中央静脉导管中是有效和安全的。与导管尖端的潜在风险因素包括较老年，女性性别，癌症，肺病和以前的中央静脉导管。

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