Identification and repositioning of catheter malposition during PICC insertion in 113 cancer patients / 中华护理杂志

This paper summarized identification and reposition strategies of catheter malposition in 113 cancer patients with peripherally inserted central catheters(PICCs) during catheterization.In the process of PICC catheterization,catheter malposition was identified by ultrasound and ECG in a real-time manner.A series of timely and effective reposition procedures were performed by internal jugular vein blocking,breathing combined with anterior segment wire withdrawal Overall,111 cases were successfully repositioned,the success rate was 98.23％,and 2 cases failed because of other reasons such as diseases.

Related complications of implantable venous access port / 局解手术学杂志

Objective To explore the incidence and clinical treatment of related complications caused by implantable venous access port(IVAP) in patients with breast cancer during chemotherapy.Methods The data of 755 patients with breast cancer recieved chemotherapy by which caused some related complications in our hospital from January 2014 to March 2016 were retrospectively analyzed.Results 753 patients IVAPs were implanted succussfully.The total placement time of implantable venous access port was from 110 days to 940 days,with median placement 147.33 days.The related complications of IVAP were catheter malposition(0.79％,6/755),catheter-related thrombosis(27.81％,210/755),catheter fracture(0.13％,1/755),port exposure(0.93％,7/755) and IVAP-related bloodstream infection(0.13％,1/755).The IVAP-related complications and thrombosis rate were significant higher when IVAPs implanted in the left internal jugular veincompared with that in right internal jugular vein(34.88％ vs.25.74％,33.10％ vs.24.68％).Conclusion Application of IVAP in patients with breast cancer during chemotherapy is a safe and effective operation.The most common complication is asymptomatic mural thrombus formation around the catheter,which should be paid attention to.

Central venous catheter malposition due to dialysis catheter: a case report / 대한마취과학회지

A 56-year-old man on maintenance hemodialysis was admitted to the intensive care unit with septic shock and coagulopathy. As there was a dialysis catheter in the right internal jugular vein, the left internal jugular vein was cannulated with a central venous catheter to initiate vasopressor therapy. A chest X-ray showed formation of a catheter loop inside the left brachiocephalic vein, probably due to hindrance by the dialysis catheter. This report describes the hurdles encountered, repeated cannulation attempts, and serial chest X-ray findings required to obtain acceptable placement of the catheter tip.

A Meta-analysis of the related factors of PICC malposition / 中国实用护理杂志

Objective To identify the related factors of PICC malposition.Methods The domestic published literature about the related factors of PICC malposition were collected from 2001 to 2014.Analysis of heterogeneity was performed and cumulative effects were calculated using either fixed or random effects models by RevMan 5.0.Results The incidence of PICC malposition in patients with median cubital vein or cephalic vein was obviously higher than that in patients with basilic vein,the incidence of PICC malposition in patients with cephalic vein was significantly higher than that in patients with median cubital vein; the incidence of PICC malposition in patients with recumbent position was significantly higher than that in patients with seat position; the incidence of PICC malposition in the older than sixty years patients was significantly higher than that in younger than sixty years patients; the incidence of PICC malposition in male and female patients was not discrepant.Conclusions The vein,position and age of patient are the related factors of PICC malposition,while sex factor has nothing to do with the occurrence of PICC malposition.

Central venous catheter malposition in the left internal thoracic vein via the left internal jugular vein: A case report

Central venous catheterization is widely used for patient monitoring and drug administration during the perioperative period. However, several complications could occur during the procedure; a catheter malpositioning is one of the rare complications that have been reported. Thus, we report the case of central venous catheter malpositioning in the left internal thoracic vein via the left internal jugular vein.

Central venous catheter malposition in the left internal thoracic vein via the left internal jugular vein: A case report

Central venous catheterization is widely used for patient monitoring and drug administration during the perioperative period. However, several complications could occur during the procedure; a catheter malpositioning is one of the rare complications that have been reported. Thus, we report the case of central venous catheter malpositioning in the left internal thoracic vein via the left internal jugular vein.

Observation and analysis of malposition of catheter during PICC at different body positions / 中国实用护理杂志

Objective To study the incidence of malposition of catheter at different body positions during the operation of peripherally inserted central catheter (PICC),and then select the optimum position to increase the success rate of insertion. Methods 155 patients were randomly divided into the horizontal position group (55 cases),the semi-reclining position group (49 cases) and the sitting position group (51cases).They all used chest X-ray to conffirm the position of top end of the catheter after insertion and then comparing the incidence rate of malposition of catheter among three groups. Results After insertion,11 patients' catheters were found malposition.Among them,8 patients were in the semi-reclining position group (incidence rate 16.3％),2 patients were in the horizontal position group (incidence rate 3.6％) and only one patient was in the sitting position group (incidence rate 1.9％ ).Incidence rate of catheter malposition in the semi-reclining position group was significantly higher than other two groups. Conclusions The best position for PICC is the horizontal position.If the patient has expiratory dyspnea or need to adjust the malposition catheter,sitting position can be used.Semi-reclining position should be avoided in the operation of PICC.

Epidural Catheter Malposition in a Failed Epidural Anesthesia Confirmed by Computed Tomography

We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure using standardized techniques such as loss of resistance, we recommend performing the procedure under fluoroscopic guidance to improve success rate and patient safety.

Epidural Catheter Malposition in a Failed Epidural Anesthesia Confirmed by Computed Tomography

We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure using standardized techniques such as loss of resistance, we recommend performing the procedure under fluoroscopic guidance to improve success rate and patient safety.