Abstract
Objective To analyze the relevant materials of cases found with difficulty in removing peripherally inserted central catheters (PICC) and to preliminarily explore its causes and risk factors. Methods The medical history of totally 26 patients with difficulty in removing PICC in the Department of Vascular Surgery of Tianjin Medical University General Hospital between May 2012 and December 2016 was retrospectively analyzed with descriptive statistical analysis. Results Among these patients, 13 received PICC radiography plus perspective PICC extubation; 7 received PICC extubation through venotomy with general or local anesthesia; and 1 received PICC extubation by precava and right ventricular angiography and right intracardiac insertion through femoral vein. The suspected risk factors to difficulty in removing PICC included age, hematological malignancy, chemotherapy, discharge with PICC, infection, transfusion history, duration of PICC and level of D-double polymer. The causes of difficulty in extubation mainly were phlebothrombosis, catheter fracture, adhesion between catheters and vessel wall, local fibrous tissue package in catheters, catheter deformation and circuity in venous vein. Conclusions During the period with catheters, catheter maintenance and management shall be strictly performed with regular check over D-double polymer and routine ultrasonic testing before extubation. When removing the catheter, nurses should pay attention to psychological nursing for patients to reduce the incidence of extubation difficulty and improve patients' satisfaction. Key words: Peripherally inserted central catheter; Extubation difficulty; Influencing factors
Published Version
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