Risk factors for development of complication following peripherally inserted central catheters: A retrospective analysis of 850 patients

Abstract

Objectives: Peripherally inserted central venous catheters (PICCs) are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia Methods: ‘Central Venous Catheterization Forms\' filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009 and March 2013 in the operating room of Uludag University Medical Faculty Hospital were retrospectively analysed. Results: A total of 1174 procedures were evaluated. The most preferred vein for the first attempt was the right basilic vein (32.7%). Difficulty (more than two attempts) with the PICC procedure was correlated with the patient\'s age (p

Keywords

• Peripheral venous catheterization, complications, risk factors, incidence.

Periferik yerleştirilen santral venöz kateterleri takiben komplikasyon gelişmesi risk faktörleri: 850 hastanın retrospektif analizi

Abstract

Amaç: Periferik yerleştirilen santral venöz kateterler (PYSK), üst ekstremite venleri kullanılarak kalbe dökülen büyük venlere ulaşılmasını sağlayan araçlardır. Bu çalışmada genel anestezi uygulamalarımız sırasında gerçekleştirdiğimiz PYSK girişimlerini retrospektif olarak inceleyerek, girişime bağlı komplikasyonları, bunların nedenlerini ayrıca girişimin başarısını etkileyen faktörleri belirlemeyi amaçladık. Yöntemler: Uludağ Üniversitesi Sağlık Uygulamaları Araştırma Merkezi Hastanesi ameliyathanesinde Kasım 2009 – Mart 2013 tarihleri arasında genel anestezi uygulamalarımız sırasında asistanlar tarafından PYSK uygulaması yapılan ve “Santral Venöz Kateterizasyon Formu” doldurulan 850 hastaya ait formlar retrospektif olarak incelendi. Bulgular: Hastalara toplam 1174 girişim yapıldığı ve ilk girişim için en çok sağ bazilik venin (%32,7) tercih edildiği görüldü. PYSK uygulamasının, zorluk (ikiden fazla deneme gereken) nedenleri incelendiğinde; hasta yaşı (p

Keywords

• Periferik venöz kateterizasyon, komplikasyonlar, risk faktörler, insidans

References

1. Joshi S, Kulkarni A, Bgargava AK. Evaluation of length of central venous catheter inserted via cubital route in indian patients, Indian J Crit Care Med 2010:14- 4;180-184
2. Al Raiy B, Fakih MG, Bryan-Nomides N. et al. Periph- erally inserted central venous catheters in the acute care setting: A safe alternative to high-risk short- term central venous catheters, Am J Infect Control 2010;38:149-153.
3. Hertzog DR, Waybill PN. Complications and contro- versies associated with peripherally inserted central catheters, J Infus Nurs 2008;31:159-163.
4. Chlebicki MP, Teo EK. Review of peripherally inserted central catheters in the Singapore Acute-Care Hospi- tal. Singapore Med J 2003;44:531-535.
5. Venkatesan T, Sen T, Korula PJ, et al. Blind placements of peripherally inserted antecubital central catheters: initial catheter tip position in relation to carina, Br J Anaesth, 2007;98-1:83–88.
6. Pittiruti M, Brutti A, Celentano D, et al. Clinical expe- rience with power-injectable PICCs in intensive care patients. Crit Care 2012;16.
7. Merrell SW, Peatross BG, Grossman MD, et al. Pe- ripherally inserted central venous catheters low-risk alternatives for ongoing venous Access. West J Med 1994;160-1;25-30.
8. Philip K, Mark JA, Gray E, Lawrence M. Peripherally inserted central catheters in general medicine. Mayo Clinic Proc 1997;72:225-233.

9. Eisen LA, Narasimhan M, Berger JS. et al. Mechanical complications of central venous catheters. J Intensive Care Med 2006;21:40-46.
10. Bo-Linn GW, Anderson DJ, Anderson KC, McGoon MD. Percutaneous central venous catheterization performed by medical house officers: a prospective study. Cathet Cardiovasc Diagn 1982;8:23-29.
11. Pikwer A, Baath L, Davidson B, et al. The incidence and risk of central venous catheter malpositioning: a prospective cohort study in 1619 patients. Anaesth In- tensive Care 2008;36:30-37.
12. Evans RS, Sharp JH, Linford LH, et al. Risk of symp- tomatic DVT associated with peripherally inserted central catheters. Chest 2010;138-4:803-810.
13. Sposato LA, Yap CH, Powar N, et al. Acute mediasti- nitis secondary to venous perforation by a peripherally inserted central venous catheter. J Cardiothorac Vasc Anesth 2009;23-5:672-674.
14. Bivins MH, Callahan MJ. Position-dependent ven- tricular tachycardia related to a peripherally inserted central catheter. Mayo Clin Proc 2000;75:414-416.
15. Racadio JM, Doellman DA, Johnson ND, et al. Pediat- ric peripherally inserted central catheters: Complica- tion rates related to catheter tip location. Pediatrics 2001;107:128.
16. Smith B, Neuharth RM, Hendrix MA, et al. Intrave- nous electrocardiographic guidance for placement of peripherally inserted central catheters, J Electrocar- diol 2010;43:274–278.
17. Capozzoli G, Accinelli G, Fabbro L, et al. Intra-cavitary ECG is an effective method for correct positioning of the tip of tunneled Groshong catheters, J Vasc Access 2012;13-3:393-396.
18. Nancy LM, Glenda LD, Elizabeth A, Robyn S. Elec- trocardiogram (EKG) Guided Peripherally Inserted Central Catheter Placement and Tip Position: Results of a Trial to Replace Radiological Confirmation, JAVA, 2010;15-1:8-14.
19. Minkowich L, Djaiani G, McCluskey SA, et al. Fre- quent malpositions of peripherally inserted central ve- nous catheters in patients undergoing head and neck surgery, Can J Anesth 2011;58:709–713.
20. Schummer W, Schummer C, Rose N, et al. Mechani- cal complications and malpositions of central venous cannulations by experienced operators: A prospective study of 1794 catheterizations in critically ill patients. Intensive Care Med 2007;33:1055–1059.
21. Mansfield PF, Hohn DC, Fornage BD, et al. Complica- tions and failures of subclavian-vein catheterization. N Engl J Med 1994;331:1735-1738.
22. Yilmazlar A, Bilgin H, Korfali G, et al. Complications of 1303 central venous cannulations. J Royal Soc Med 1997;90:319-321.
23. Pikwer A, Åkeson J, Lindgren S. Complications as- sociated with peripheral or central routes for central venous cannulation. Anaesthesia 2012;67:65–71.
24. Amerasekera SS, Jones CM, Patel R, Cleasby MJ. Imaging of the complications of peripherally inserted central venous catheters. Clin Radiol 2009;64:832- 840.
25. Philip K, Mark JA, Gray E, Lawrence M. Peripherally inserted central catheters in general medicine. Mayo Clinic Proc 1997;72:225-233.
26. Zhang Y, Jiang H, Wei L, Yu H. Persistent hiccup caused by peripherally inserted central catheter mi- gration. J Anesth 2011;25:625–626.
27. Tran HS, Burrows BJ, Zang WA, Han DC. Brachial arteriovenous pistula as a complication of placement of a peripherally inserted central venous catheter: A case report and review of the literatüre. Am Surg 2006;72:833-836.