Abstract
Peripherally inserted central catheters (PICCs) play a critical role in the infusion of parenteral nutrition, chemotherapy and intravenous fluids for the increased safety and efficacy for long-term use. However, during the insertion and management of PICCs, there are still some PICC-related complications need to be reduced as much as possible for both operators and researchers. In this case, the tunneled-PICC provides a new “a nedesl subcutaneous route” technology for PICC application. This article reviews the principle and characteristics of tunneled-PICC. Tunneled PICCs, seems to be a safe option and easy to perform as an alternative to standard placement for its advantages of the better exit location, reduced incidences of thrombosis and infection, reduced the shift rate as well as extended retention time. However, more research on the standard tunneling technique and large-scale clinical applications need to be proposed.
Highlights
Inserted Central Catheters (PICCs) which can be inserted into central venous veins via peripheral veins, such as the cephalic vein, basilic vein or brachial vein, are usually used in the treatment of medium to long-term intravenous infusion, irritating drugs infusion and intermittent infusion of chemotherapeutic drugs [1,2]
The intracavitary electrocardiogram (IC-ECG) method has been proved to be safe, accurate and highly cost-effective, because it saves the expenses related to post-procedural X-ray confirmation and possible repositioning of malpositioned catheters [7,8,9]
The Peripherally Inserted Central Catheters (PICCs) Zone Insertion Method (ZIM) proposed by Dawson is a systematic approach to PICC insertion for the purpose of results optimization and the reduction in patient risk [18]
Summary
Inserted Central Catheters (PICCs) which can be inserted into central venous veins via peripheral veins, such as the cephalic vein, basilic vein or brachial vein, are usually used in the treatment of medium to long-term intravenous infusion, irritating drugs infusion and intermittent infusion of chemotherapeutic drugs [1,2]. The successful PICC insertion technique has three developments, the anatomical landmark method, the ultrasound technology and the intracavitary electrocardiogram (IC-ECG) method [4]. Despite the numerous benefits of PICCs, all-cause PICC-related complication rate is 11.77% to 17% [10,11,12], including infection, pain, bleeding, and mechanical dysfunction, all of which contribute to patient discomfort and additional healthcare costs [13, 14]. Peripheral vascular conditions, prolonged bed rest, trauma, burns, localized skin damage, scarring, and low immunity. It brings about an additional manipulation and the presence of a small surgical wound in the axillary area that, in some cases, may determine an incomplete closure, leaving uncovered a portion of the catheter in the subcutaneous level [21]
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