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; P<0.001), 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; P<0.001), and previous catheter insertions (Exp(B), 1.262; 95% CI, 1.126 to 1.414; P<0.001). 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.
Citations
Citations to this article as recorded by
The Outcomes of Peripherally Inserted Central Catheter (PICC) Insertion in Pediatric Patients at Siriraj Hospital Niracha Wongchompoo, Khanita Kasikan, Prasert Sawasdiwipachai Siriraj Medical Journal.2024; 76(3): 135. CrossRef
Catheter detection by transthoracic echocardiography during placement of peripherally inserted central catheters: a real-time method for eliminating misplacement Yong Chae Jung, Man-shik Shim, Hee Sun Park, Min-Woong Kang Acute and Critical Care.2024; 39(2): 266. CrossRef
Effectiveness of a nurse-led peripherally inserted central catheter service: A retrospective cohort study Kawthar Alsaleh, Dalyal Alosaimi, Adnan Almousawi, Mohammed Alshaikh, Hisham Omar The Journal of Vascular Access.2024;[Epub] CrossRef
Factors Associated with Successful First-attempt Puncture in Pediatric Patients Undergoing Ultrasound-guided Peripherally Inserted Central Catheter Midan Zhang, Xiaofei Chen, Hongqin Zhou, Meifang Xu Innovative Journal of Pediatrics.2023;[Epub] CrossRef
Factors Associated with Successful First-attempt Puncture in Pediatric Patients Undergoing Ultrasound-guided Peripherally Inserted Central Catheter Midan Zhang, Xiaofei Chen, Hongqin Zhou, Meifang Xu Iranian Journal of Pediatrics.2023;[Epub] CrossRef
Feasibility of Ultrasound-Guided, Peripherally Inserted Central Catheter Placement at the Bedside in a Communicable-Disease Isolation Unit Kyoung Won Yoon, Wongook Wi, Moon Suk Choi, Eunmi Gil, Chi-Min Park, Keesang Yoo Journal of Personalized Medicine.2023; 13(5): 863. CrossRef
Development and validation of an updated PICC length prediction formula based on anteroposterior chest radiographs for the ultrasound-guided bedside placement Hyoung Nam Lee, Sangjoon Lee, Sung-Joon Park, Youngjong Cho, Hwan Hoon Chung, Robert Jeenchen Chen PLOS ONE.2023; 18(11): e0294598. CrossRef
Analysis of tip malposition and correction of peripherally inserted central catheters under ultrasound-guidance: 5-year outcomes from a single center Eunju Jang, Soo Mi Son, Ki-yoon Moon, Seunghoon Lee, Hong Seok Han, Sun Cheol Park, Jang Yong Kim, Sang Seob Yun The Journal of Vascular Access.2023;[Epub] CrossRef
Precision at the Bedside: Practical Efficacy of Clockwise Catheter Torque for Accurate Tip Positioning of Peripherally Inserted Central Catheters Masayuki Akatsuka, Eriko Sugiyama Cureus.2023;[Epub] CrossRef
Guidewire-Assisted Reduction Technology Combined with Postural Reduction Improves the Success Rate of Internal Vein Catheterisation Feng-Xian Li, Yan-Ping Li, Hong-Yang Zhang, Mei-Jing Tian, Huan-Huan Gao, Gui-Juan Zhang, Peng Su, Daniel Espino Journal of Healthcare Engineering.2022; 2022: 1. CrossRef
Therapeutic Effect of Ultrasound-Guided Peripherally Inserted Central Catheter Combined with Predictive Nursing in Patients with Large-Area Severe Burns Baiyan He, Aiqiong Zhang, Shuting He, Pan Zheng Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
Bedside peripherally inserted central catheter placement: focus on the procedure Dong Hun Kim Trauma Image and Procedure.2022; 7(1): 21. CrossRef
Validation of the PICC length prediction formula based on anteroposterior chest radiographs for bedside ultrasound-guided placement Youngjong Cho, Sangjoon Lee, Sung-Joon Park, Hyoung Nam Lee, Hwan Hoon Chung, Robert Jeenchen Chen PLOS ONE.2022; 17(11): e0277526. CrossRef
Feasibility of Peripherally Inserted Central Catheter Placement in COVID-19 Patients Isolated in the Intensive Care Unit of a Small Volume Center (291-Bed Hospital) Min Chang Kang, Kyungwon Lee Journal of Acute Care Surgery.2022; 12(3): 125. CrossRef
Prevalence of complications associated with the use of a peripherally inserted central catheter in newborns: A systematic review protocol Edienne Rosângela Sarmento Diniz, Kleyton Santos de Medeiros, Richardson Augusto Rosendo da Silva, Ricardo Ney Cobucci, Angelo Giuseppe Roncalli, Raffaele Serra PLOS ONE.2021; 16(7): e0255090. CrossRef
Ultrasound-guided insertion of peripherally inserted central catheter after anesthetic induction in children undergoing surgery for moyamoya disease - Thirty cases report- Sang-Hwan Ji, Sol Ji Yoo, Sung-Ae Cho, Young-Eun Jang, Eun-Hee Kim, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim Anesthesia and Pain Medicine.2021; 16(3): 273. CrossRef
Comparing the accuracy and complications of peripherally inserted central catheter (PICC) placement using fluoroscopic and the blind pushing technique Brendan Erskine, Pierre Bradley, Tim Joseph, Sabrina Yeh, Warren Clements Journal of Medical Radiation Sciences.2021; 68(4): 349. CrossRef
Pneumothorax as a rare complication of peripherally inserted central catheter (PICC) in neonates: A case report study Rasoul Goli, Sina Zafarmokhtarian, Mahmoodreza Ghalandari, Navid Babakeshi-sheytanabad, Sajjad Rostami, Hossna Farajollahi International Journal of Surgery Case Reports.2021; 88: 106472. CrossRef