Study of the correlation between different upper limb abduction angles and the occurrence of malposition of PICC into internal jugular vein / 中华护理杂志

ABSTRACT

Objective To investigate the effects of different upper limb abduction angles on the occurrence of malposition of PICC into internal jugular vein. Methods Totally 210 cases of patients treated with PICCs for unilateral breast cancer of our hospital from August,2015 to January,2017 were randomly assigned to three groups with 70 cases in each group. The abduction angle of the upper limb for placement was set at 45° ,90° and 160° , respectively. We chose the basilic vein of the uninfected arm using modified Seldinger technique under the guidance of ultrasound for PICC,and malposition was confirmed by detecting the tip of PICC in internal jugular vein. Results The incidence rate of internal jugular venous dislocation in 45° group was 7.14%(5 cases) and 8.57% in 90° group (6 cases),and no internal jugular venous dislocation in 160° group. There was no statistically significant difference among 45°,90° and 160° groups(χ2=5.95,P>0.05). Significant differences of group comparisons for 45° v.s. 160° and 160° v.s. 90° were found (P0.05). Conclusion Abduction angles of 45° ,90° and 160° can all be used for PICC placement. The abduction angle can be selected according to specific situation of patients instead of being limited to the standard abduction angle of 90°.