PICC Catheter Research Articles

Performance and safety of PowerPICC catheters and accessories: a prospective observational study

ObjectiveThis study aimed to evaluate the safety and performance of PowerPICC catheters in a real-world setting.DesignProspective, observational, multicentre study.SettingNine European countries, involving 14 centres.ParticipantsGeneral patient population.InterventionPowerPICC catheter inserted by the...

Different modes of ankle pump exercise to prevent PICC-related thrombosis through femoral vein.

To explore the preventive effect of different modes of ankle pump exercise on femoral vein PICC catheter-related thrombosis. Convenient sampling method was used to select 172 patients with lung cancer with PICC catheterization through femoral vein admitted to West China Hospital of Sichuan University as the observation group and control group. Comfort angle ankle pump exercise mode and maximum angle ankle pump exercise mode were adopted. We have compared the differences in the incidence of catheter-related thrombosis, unplanned catheter removal, fatigue score, and catheter retention time between two groups of patients. The incidence of catheter-related thrombosis, unplanned catheter removal, fatigue score, and catheter retention time were statistically significant (p < .05) in both groups of patients. The maximum angle ankle pump exercise mode can reduce the incidence of catheter-related thrombosis and unplanned catheter removal in patients with lung cancer with PICC catheterization through femoral vein, increase catheter retention time, but it can easily cause patient fatigue. In clinical practice, patient tolerance should be considered.

The Construction and Application of an Internet-based Hospital-community-family Home Management Model

Objective: Based on the software, this study aims to develop a hospital-community-home management model and evaluate the impact of nursing interventions provided by home visiting nurses, aligning with national healthcare policies in China. Methods: In the Dongying area, hospitals collaborate closely with local communities and families to facilitate the smooth implementation of Internet + Nursing Services. Patients schedule appointments for a range of medical care services through mobile phone software, with staff accessing orders through the platform to provide professional treatment and nursing care to patients. Results: Currently, there are 214 registrants from 50 departments on the platform. From September 2021 to June 2023, a total of 3529 cases were handled the platform. The top 10 order items included heel blood collection (944 cases), graphic consultation (526 cases), neonatal jaundice measurement (463 cases), neonatal hearing screening (418 cases), gastrostomy tube care (368 cases), catheterization care (192 cases), venous blood sampling (155 cases), postpartum mammary gland unblocking (103 cases), surgical wound care (92 cases), PICC catheterization care (57 cases), and pressure tube placement care (57 cases). Conclusion: The hospital has successfully established a hospital-community-family home nursing model with specialist nurses playing a central role. Through the implementation ofInternet + Nursing Service, medical staff are able to provide quality medical and nursing care to patients who are unable to leave their homes, significantly improving patient convenience and conserving medical resources.

Analysis of the Nursing Effect of Hierarchical Extended Nursing Based on The Guidance of Orem’s Theory in Patients with PICC Catheterization

Objective: To analyze the nursing effect of hierarchical extended nursing based on the guidance of Orem’s theory in patients with peripherally inserted central (PICC) catheterization. Methods: Ninety-one patients with PICC catheterization admitted to the hospital from May 2021 to May 2023 were selected and divided into a control group and an observation group, with 45 and 46 cases, respectively. The control group received routine nursing care, while the observation group received routine nursing care combined with hierarchical extended nursing based on the guidance of Orem’s theory for 3 months. Relevant indicators between the two groups were compared. Results: The improvement degree of various indicators in the observation group after nursing was better than that of the control group (P &lt; 0.05). Conclusion: Graded extended nursing based on the guidance of Orem’s theory improved the knowledge, belief, behavior, and self-efficacy of patients with PICC catheterization, and relieved their anxiety, depression, and other negative emotions. The nursing effect was deemed to be significant.

Risk factors analysis and the establishment of nomogram prediction model for PICC-related venous thrombosis in patients with lymphoma: a double-center cohort-based case-control study.

The objective of this study is to examine the risk factors associated with the occurrence of PICC-Related Venous Thrombosis (PICC-RVTE) in individuals diagnosed with lymphoma, as well as to develop a predictive risk nomogram model. A total of 215 patients with lymphoma treated at Yunnan Provincial Tumor Hospital from January 2017 to December 2020 were retrospectively evaluated as the training cohort; 90 patients with lymphoma treated at the Department of Oncology of the First People's Hospital of Anning, Affiliated to Kunming University of Science and Technology during the January 2021 to September 2023 were evaluated as the validation cohort. Independent influencing factors were analyzed by logistic regression, a nomogram was developed and validated, and the model was evaluated using internal and external data cohorts for validation. A total of 305 lymphoma patients were selected and 35 (11.48%) PICC-RVTE occurred, the median time was 13 days. The incidence within 1-2week was 65.71%. Multivariate analysis suggested that the activity amount, thrombosis history(within the last 12 months), ATIII, Total cholesterol and D-dimer levels were independently associated with PICC-RVTE, and a nomogram was constructed based on the multivariate analysis. ROC analysis indicated good discrimination in the training set (area under the curve [AUC] = 0.907, 95%CI:0.850-0.964) and the testing set (AUC = 0.896, 95%CI: 0.782-1.000) for the PICC-RVTE nomogram. The calibration curves showed good calibration abilities, and the decision curves indicated the clinical usefulness of the prediction nomograms. Patients should be advised to undergo color Doppler ultrasound system testing within two week after the implantation of a PICC catheter to detect PICC-RVTE at an early stage. The validated nomogram can be used to predict the risk of catheter-related thrombosis (CRT) in patients with lymphoma who received at least one chemotherapy after PICC catheterization, no bleeding tendency, no recent history of anticoagulant exposure and no severe heart, lung, renal insufficiency. This model has the potential to assist clinicians in formulating individualized treatment strategies for each patient.

The Use of a High Flow PICC Catheter for Stem Cell and Lymphocyte Apheresis: The Initial Experience of a Pediatric Oncology Center in Brazil

BackgroundAutologous hematopoietic stem cell transplant (HSCT), characterized by high intensity chemotherapy followed by the infusion of HSC previously collected from the peripheral blood, is a procedure used in the treatment of several malignancies. In pediatrics, the apheresis procedure represents a challenge, due to the need for insertion of a rigid central venous catheter (CVC) in small children. The CVC is usually used for stem cell collection and then removed. Later, the patient will need a new device for cell infusion. AimWe propose the use of one single catheter for both apheresis and infusion. MethodsWe present five children between 1 and 13 years of age who underwent apheresis using a high flow PICC catheter surgically inserted. ResultsAll patients utilized a PICC line double lumen 5Fr (PowerPICC™ 5Fr DL BARD/USA) placed in the brachiocephalic vein tunneled on the chest, inserted under 24 h prior to apheresis to assure the devices were pervious. Three of the patients were diagnosed with solid tumor and one with acute lymphoblastic leukemia (ALL) awaiting Car-T Cell therapy. The four children who underwent autologous HSCT used the same catheter for cell infusion and remained with the catheter following discharge. The child who was submitted for Car-T Cell still awaits infusion and the catheter was removed. ConclusionsHigh flow PICC is a viable alternative for apheresis to maintain an adequate flow of 5 ml/s and can be used as a single catheter throughout the HSCT process, reducing the risks from anesthesia and the catheter insertion procedure. Type of StudyClinical Research.

Synthetic Haemostatic Sealants: Effectiveness, Safety, and In Vivo Applications.

Rapid haemostasis during surgery is essential when one wants to reduce the duration of operations, reduce the need for transfusions, and above all when one wants to achieve better patient management. The use of haemostatic agents, sealants, and adhesives improves the haemostatic process by offering several advantages, especially in vascular surgery. These agents vary widely in their mechanism of action, composition, ease of application, adhesion to wet or dry tissue, immunogenicity, and cost. The most used are cyanoacrylate-based glues (Glubran 2) or polysaccharide hydrogel-microsphere powder (AristaTMAH). This work is based on a retrospective study carried out on a sample of patients with different vascular diseases (FAV, pseudoaneurysm, and PICC application) in which two different haemostatic sealants were used. The aim was to assess the safety, the advantages, and the ability of both sealants to activate the haemostatic process at the affected site, also in relation to their chemical-physical characteristics. The obtained results showed that the application of Glubran 2 and AristaTMAH as surgical wound closure systems is effective and safe, as the success achieved was ≥94% on anastomoses of FAV, 100% on stabilization of PICC catheters, and ≤95% on pseudoaneurysms.

The impact of internet multidisciplinary continuity care on the living quality of home-based patients with malignant tumors undergoing PICC catheterization.

To evaluate the impact of Internet-based multidisciplinary continuity care on the quality of life of home-based patients with PICC catheters for malignant tumors. This study is a retrospective research analysis. A total of 131 patients with malignant tumors who received PICC catheterization at Xijing Hospital from Jan. 2023 to Dec. 2023 were enrolled in this study. Patients were divided into two groups: 61 in the control group who received conventional nursing care, and 70 in the observation group who received multidisciplinary continuous nursing care via an Internet platform in addition to conventional nursing. The Strategies Used by Patients to Promote Health (C-SUPPH), the Quality-of-Life Core Questionnaire (QLQ-C30), the Exercise of Self-care Agency Scale (ESCA), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were adopted for investigation and analysis. Six months after intervention, the two groups' ego-efficacy, living quality, self-care ability and psychological status, as well as treatment compliance and satisfaction with care were compared. Post-intervention, both groups showed significant improvements in ego-efficacy and self-care ability scores (all P<0.05). The observation group scored higher in all dimensions of ego-efficacy and self-care ability compared to the control group (all P<0.05). Furthermore, the observation group demonstrated significant improvements across all dimensions of quality of life (P<0.05), whereas the control group only showed improvement in social function (P<0.05). The observation group also exhibited lower scores for anxiety and depression post-intervention compared to the control group (all P<0.05). Additionally, the observation group had a significantly lower incidence of complications and higher post-intervention treatment compliance and satisfaction with nursing (P<0.05). Multidisciplinary continuing nursing care delivered via an Internet platform significantly enhances self-management efficiency, quality of life, and self-care ability of home-based patients with PICC catheters for malignant tumors. This care model also effectively improves patients' mental health and increases their compliance with treatment and satisfaction with nursing.

Implementation of a vascular access specialist team in a tertiary hospital: a cost-benefit analysis

BackgroundThe use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. The objective of the study is to evaluate previously to the implementation whether the benefits of introducing ultrasound-guided peripheral venous catheters, midline catheters and peripherally inserted central catheters compared to current practice by a vascular access specialist team outweigh their costs.MethodsCost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when changing the current practice for the use of ultrasound-guided midline and PICC catheters, as well as the additional resources required for their use.ResultsThe use of an ultrasound-guided device on peripherally inserted central carheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, the use of an ultrasound-guided device on a midline catheter, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96.ConclusionThe benefits of using ultrasound-guided midline and PICC catheters compared to current practice by introducing a vascular access specialist team trained in the implantation of ultrasound-guided catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of phebitis. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.

A multi-national survey of experience and attitudes towards managing catheter related blood stream infections for home parenteral nutrition

Catheter-related bloodstream infection (CRBSI) is the most common complication of home parenteral nutrition (HPN) in patients with chronic intestinal failure (CIF). The aim of this study was to assess the broad range of practices of international multi-disciplinary teams involved in the care of this complication occurring in CIF patients. An online questionnaire was designed and distributed to members of the European Society for Clinical Nutrition and Metabolism (ESPEN) and distributed to colleagues involved in managing patients with CIF. A total of 47 responses were included from centers across 21 countries. The centers had been delivering HPN for a median 21 years (IQR 11-35) and were actively following a median 58 patients (27-120) per center for benign CIF in 80% of cases (67-95). Tunneled catheters were the most common type of central venous catheters (CVC), representing 70% (47-86) of all CVC in use. For the management of CRBSI, written procedures were provided in 87% of centers. First measures included simultaneous central and peripheral blood cultures (90%), stopping HPN infusion (74%), and administrating an antibiotic lock and systemic antibiotics (44%). Immediate removal of the CVC was more likely in case of fungal infection (78%), Staphylococcus aureus (53%), or in case of PICC catheter (52%) (all p<0.01). After the first CRBSI, 80% of centers used preventive CVC locks (taurolidine in 84% of cases, p<0.001). We observed a large heterogeneity in practices regarding preparation, duration, reaspiration, and volume of CVC locks, and monitoring of CRBSI (timing of blood cultures, radiological work-up). In this international survey of HPN expert centers, we observed a significant consensus regarding the initial management of CRBSI and the use of secondary preventive CVC locks, while areas of variation exist. Management of CRBSI may be improved with clearer recommendations based on the micro-organism and the type of CVC, including PICC lines which are increasingly used yet insufficiently studied in HPN patients.

Clinical factors of PICC-RVT in cancer patients: a meta-analysis.

There is a lack of studies that systematically evaluate the clinical factors of PICC-RVT such as treatment, tumor stage, metastasis, and chemotherapy drugs in cancer patients. This study, therefore, aims to evaluate the clinical factors of catheter-related venous thrombosis in cancer patients with indwelling PICC to provide a basis for the clinical prevention and reduction of thrombosis. Relevant studies were retrieved from major databases (PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Data, and China Biology Medicine disc (CMB)) and searched from their earliest available dates until July 2022. If two or more studies had the same outcome, a meta-analysis using RevMan 5.4.1 was performed. This systematic review was registered at PROSPERO (number CRD42022358426). A total of 19 articles involving 19,824 patients were included for quantitative analysis. Meta-analysis of these studies indicated that a history of chemotherapy, tumor type, tumor stage, presence or absence of metastasis, and use of fluorouracil, etoposide, platinum drugs, and taxane were all risk factors for PICC catheter thrombosis in cancer patients. In clinical PICC catheter thrombosis prevention, patients with the above characteristics should be watched more closely than other patients, as they have a higher risk for PICC catheter thrombosis. Based on the present evidence at hand, radiotherapy cannot be considered to be related to the formation of PICC-RVT in cancer patients.

A prospective observation of PICC related anaphylactoid reactions.

To explore the incidence, signs and symptoms, causes and prognosis of anaphylactoid reactions in PICC catheterization. Prospectively observe the occurrence of anaphylactoid reactions in coated and uncoated PICC during insertion from November 2018 to April 2020. A diagnosis of anaphylactoid reactions was based on the signs and symptoms and laboratory results, and then collect data for analysis. A total of 1439 coated catheters were inserted, of which 30 resulted in anaphylactoid reactions (2.08%). The signs and symptoms were mainly skin system symptoms, combined with respiratory, cardiovascular, and digestive system symptoms. The anaphylactoid reaction rates of coated catheters were higher than those of uncoated catheters (χ2 = 38.417, 19.352, p < .01). A 29 of 30 patients completed catheterization after symptoms were resolved, these catheters were removed after treatment completion. Catheterization was terminated in one patient. There were no anaphylactoid reactions in 2850 uncoated catheters. Anaphylactoid reactions may occur during catheterization when using the coated PICC, which should be paid attention to in clinical application.

Impact of distance of the catheter tip from cavo-atrial junction on bubble test (delay) time: A prospective study.

Correct tip positioning is a critical aspect in central vascular access devices insertion. The verification of positioning at the cavo-atrial junction is usually performed by intracavitary electrocardiography. Recently, echocardiographic techniques were proposed, including the direct visualization of the catheter or the visualization of a saline/air bolus (i.e. "bubble test"). As for the latter, a push-to-bubbles delay time below 2 s was proposed to indicate a correct positioning of the catheter tip. The aim of this study was to measure the variations of the push-to-bubbles time at increasing distance from the cavo-atrial junction, to verify if a cut-off of 1-2 s correspond to a well-positioned catheter. We performed a prospective study including patients with clinical indication of positioning a peripherally inserted central catheter. The catheter tip was positioned at the cavo-atrial junction (P0) via intracavitary electrocardiography, and the push-to-bubbles delay time was measured. The catheter was then retracted 5 cm (P1) and 10 cm (P2), and the test was repeated at this positioning. Push-to-bubbles time measurements were performed off-line by analyzing an audio/video recording which included the echography screen and the voice signal of the operator. Forty-nine patients were included. The average push-to-bubble time when the catheter tip was in the reference position was 0.41 ± 0.21 s. Retraction of the PICC catheter of 5 and 10 cm determined a significant increase of the push-to-bubbles time: mean time difference was +0.34 (95% IC 0.25-0.43, p < 0.001) s between P0 and P1 (5 cm distance), and +0.77 (95% IC 0.62-0.92, p < 0.001) s between P0 and P2 (10 cm distance). When the catheter was at the reference position (i.e. cavo-atrial junction) only 2.1% of bubbles delay times were above 1 s. The push-to-bubbles time is very low when the catheter tip is at the cavo-atrial junction. This delay increases progressively with increasing distance from the target. Push-to-bubbles delay time above 1 s might indicate a catheter not close to the cavo-atrial junction.

Nursing care of a patient with difficult venous access through tunnel PICC catheterization of subclavian vein.

Nursing care of a patient with difficult venous access through tunnel PICC catheterization of subclavian vein.

Retracted: Nursing Effect and Prognosis Analysis of Self-Management Education Model Based on Protective Motivation Theory on Patients with Hematological Tumor after PICC Catheterization.

[This retracts the article DOI: 10.1155/2022/4180113.].

Effect of Pibaijin herbal cream external application combined with modified transparent dressing in the treatment of contact dermatitis after PICC catheterization

Effect of Pibaijin herbal cream external application combined with modified transparent dressing in the treatment of contact dermatitis after PICC catheterization

Analysis of the Secondary Ectopic PICC Catheter in Premature Infants and Research Progress of Nursing Intervention

Analysis of the Secondary Ectopic PICC Catheter in Premature Infants and Research Progress of Nursing Intervention

Analysis of Nursing Effect of PICC Catheterization in Chemotherapy of Malignant Tumor Patients with Diabetes Mellitus

Analysis of Nursing Effect of PICC Catheterization in Chemotherapy of Malignant Tumor Patients with Diabetes Mellitus

Discussion on the Application of Continuous Nursing in Nursing of Leukemia Patients with PICC Catheter

Discussion on the Application of Continuous Nursing in Nursing of Leukemia Patients with PICC Catheter

Nursing Effect of Avoiding PICC Catheter Infection in Patients with Blood Diseases Complicated with Diabetes Mellitus

Nursing Effect of Avoiding PICC Catheter Infection in Patients with Blood Diseases Complicated with Diabetes Mellitus