Abstract
Peripherally inserted central catheters (PICCs) play a great role in infusion of chemotherapy, parenteral nutrition, and intravenous fluid. It has the advantages of safety, convenience, long duration and low infection rate compared to central venous catheters (CVCs), becoming more and more popularized in clinical application. However, the clinical application of PICCs also causes complications, such as local infection, phlebitis, deep venous thrombosis, catheter malposition and breakage as well as liquid extravasation. The total complications rate varies mainly for three aspects: patients-related, catheter-related and operation-related. Disease types and severity of patients have been deeply researched. More concerns have been paid on the technology of catheter and operation to decrease the related complications. The intracavitary electrocardiogram (IC-ECG) method has been developed to be a safe, accurate and highly cost effective method. However, the traditional IC-ECG method is complicated and time consuming. Many researches have carried out to overcome the shortcomings of traditional methods. The tip-conductive PICC method came into being. The application of tip-conductive PICC greatly increases the first-attempt successful tip location and the tip location satisfactory. In this article, we reviewed the principle and characteristics of tip-conductive PICC, and comprehensive nursing care intervention including puncture, infection prevention, mechanical phlebitis, catheter blockage and catheter heterotopia and rupture.
Highlights
The incidence of cancer in China is increasing every year and the treatment of tumors is currently the focus of considerable medical research [1]
The anatomical landmark method is the basic skill for Peripherally inserted central catheters (PICCs) placement
The intracavitary electrocardiogram (IC-ECG) method has been proved to be safe, accurate and highly cost effective, for it saves the expenses related to post-procedural X-ray
Summary
The incidence of cancer in China is increasing every year and the treatment of tumors is currently the focus of considerable medical research [1]. The successful PICC insertion technique has three development, the anatomical landmark method, the ultrasound technology and the intracavitary electrocardiogram (IC-ECG) method [3, 4]. The traditional IC-ECG method acts by using a column of saline contained in the catheter as an intracavitary electrode. Mature and effective clinical insertion is the primary condition for reducing catheter-related complications. PICC complications may be fatal if not treated with effective and timely nursing care. Many effort has been made to decrease the complications, including promoting the catheter materials modification, improving the puncture procedure, fully vein evaluation and comprehensive nursing care et al The application of tip-conductive PICC increases the first-attempt successful tip location from 78.9% to 91.7%. This article reviews the principle and procedure of tip-conductive PICC, and comprehensive nursing care intervention
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