Clinical effect of peripherally inserted central catheters based on modified seldinger technique under guidance of vascular ultrasound.

Qingguo Wang,Ni Wang,Yuzhen Sun

doi:10.12669/pjms.325.10384

Abstract

Objective:To observe and analyze the application effect of ultrasound-guided modified Seldinger technique (MST) in Peripherally Inserted Central Catheter (PICC) catheterization.Methods:Two hundred patients treated with PICC catheterization from January 2013 to December 2015 were selected and randomly divided into two groups, namely, observation group and control group. The observation group adopted ultrasound-guided MST for catheterization while the control group applied traditional puncture technique for catheterization. Then efficacy of catheterization, success rate of catheterization and incidence rates of complications were compared between two groups.Results:Various indicators of catheterization effects of the observation group were better than those of the control group, and the differences were statistically significant (P<0.05); one-time success rate of puncture and catheterization of the observation group was both higher than the control group (P<0.05);. Moreover, the incidence of puncture points bleeding, phlebitis and thrombus were all lower than those of the control group (P<0.05).Conclusion:Implementing PICC catheterization based on ultrasound-guided modified Seldinger puncture technique can increase success rate of puncture, improve the effect of catheterization, lower incidence rate of adverse effects of catheterization and improve satisfaction and comfort level of patients.

Highlights

Inserted Central Catheter (PICC) makes quick dilution of intravenous dripping drugs possible and is capable of reducing stimulus of drugs to blood vessels
In 1997, Claudette Boudreaux, a nurse of intensive care unit (ICU) in medical center of Washington, used Modified Seldinger Technique (MST) to do Peripherally Inserted Central Catheter (PICC) puncture on patients under the guidance of ultrasound, which raised the success rate of bedside PICC cathetering from 65% to 91%
Failure rate of the observation group was only 2.0%, which was obviously lower than the control group (34%); Pain score of the observation group was lower than that of the control group, and the comfort levels score of the former was higher than the latter

Summary

Introduction

Inserted Central Catheter (PICC) makes quick dilution of intravenous dripping drugs possible and is capable of reducing stimulus of drugs to blood vessels It can prevent patients from suffering from pain induced by repeated puncture and intensely irritant drugs. In China, vessel puncture is a conventional puncture technique of PICC embedding, which requires thick, straight, and elastic blood vessels For those patients who are in urgent need of catheterization but with poor vein conditions, traditional PICC puncture has disadvantages for it is time consuming, and might cause great damage to local tissues.[5,6] In 1997, Claudette Boudreaux, a nurse of intensive care unit (ICU) in medical center of Washington, used Modified Seldinger Technique (MST) to do PICC puncture on patients under the guidance of ultrasound, which raised the success rate of bedside PICC cathetering from 65% to 91%.7.

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Discussion

Conclusion