Abstract
To compare the complications of peripherally inserted central catheters (PICC) by a modified Seldinger technique under ultrasound guidance or the conventional (peel-away cannula) technique. From February to December of 2010, cancer patients who received PICC at the Department of Chemotherapy in Jiangsu Cancer Hospital were recruited into this study, and designated UPICC if their PICC lines were inserted under ultrasound guidance, otherwise CPICC if were performed by peel-away cannula technique. The rates of successful placement, hemorrhage around the insertion area, phlebitis, comfort of the insertion arm, infection and thrombus related to catheterization were analyzed and compared on days 1, 5 and 6 after PICC and thereafter. A total of 180 cancer patients were recruited, 90 in each group. The rates of successful catheter placement between two groups differed with statistical significance (P<0.05), favoring UPICC. More phlebitis and finger swelling were detected in the CPICC group (P<0.05). From day 6 to the date the catheter was removed and thereafter, more venous thrombosis and a higher rate of discomfort of insertion arms were also observed in the CPICC group. Compared with CPICC, UPICC could improve the rate of successful insertion, reduce catheter related complications and increase comfort of the involved arm, thus deserving to be further investigated in randomized clinical studies.
Highlights
Inserted central venous catheter (PICC) was introduced into clinical use in the United States in 1980s
From February to December of 2010, cancer patients who received peripherally inserted central catheters (PICC) at the Department of Chemotherapy in Jiangsu Cancer Hospital were recruited into this study, and designated Ultrsound guided PICC catheterization (UPICC) if their PICC lines were inserted under ultrasound guidance, otherwise Conventional PICC catheterization (CPICC) if were performed by peel-away cannula technique
Compared with CPICC, our study suggested that UPICC could clearly identify the vascular structure, increase the successful rate of venous puncture to 98.9%
Summary
Inserted central venous catheter (PICC) was introduced into clinical use in the United States in 1980s. PICC could set up a safe and effective intravenous infusional system for cancer patients who are exposed to long-term venous medication, several adverse factors and complications, e.g. increase in economic burden, phlebitis and venous thrombosis still influence the quality of treatment (Fletcher et al, 2011; Sperry et al, 2012). Our hypothesis is that adverse with cancer and treated in the Department of Chemotherapy of Jiangsu Cancer Hoptial from February to December of 2010; to sign the informed consent before PICC; to expose to long term chemotherapy or supportive care, hyperalimentation, repeated administration of blood or blood products or venous blood sampling; to have a score of karnofsky performance status ≥ 70, and to be followed until the end of this study. Other eligibility criteria included: adequate hematological (white blood cell count > 3.0×109 and platelet count > 150×109), liver (bilirubin and transaminases < 1.5 times the upper normal limit) and renal function (creatinine leval < 1.5 times the upper normal limit); patients were excluded from the study if they had active cardiac disease (LVEF < 50%), significant arrhythmia, any serious medical or psychiatric condition
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