Cargando…

Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit

We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Yong Oh, Chung, Chi Ryang, Gil, Eunmi, Park, Chi-Min, Suh, Gee Young, Ryu, Jeong-Am
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544252/
https://www.ncbi.nlm.nih.gov/pubmed/31150465
http://dx.doi.org/10.1371/journal.pone.0217641
_version_ 1783423222943842304
author Kim, Yong Oh
Chung, Chi Ryang
Gil, Eunmi
Park, Chi-Min
Suh, Gee Young
Ryu, Jeong-Am
author_facet Kim, Yong Oh
Chung, Chi Ryang
Gil, Eunmi
Park, Chi-Min
Suh, Gee Young
Ryu, Jeong-Am
author_sort Kim, Yong Oh
collection PubMed
description We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent central line placement and were admitted to the neurosurgical intensive care unit (ICU) between January 2014 and March 2018. In this study, the primary endpoint was central line-induced complications. The secondary endpoint was initial success of central line placement. Placements of ultrasound-guided PICC and CCVC performed at the bedside if intra-hospital transport was inappropriate. Other patients underwent PICC placement at the interventional radiology suite under fluoroscopic guidance. A total of 191 patients underwent central line placement in the neurosurgery ICU during the study period. Requirement for central line infusion (56.0%) and difficult venous access (28.8%) were the most common reasons for central line placement. The basilic vein (39.3%) and the subclavian vein (35.1%) were the most common target veins among patients who underwent central line placement. The placements of ultrasound-guided PICC and CCVC at the bedside were more frequently performed in patients on mechanical ventilation (p = 0.001) and with hemodynamic instability (p <0.001) compared to the fluoroscopy-guided PICC placement. The initial success rate of central line placement was better in the fluoroscopy-guided PICC placement than in the placements of ultrasound-guided PICC and CCVC at the bedside (p = 0.004). However, all re-inserted central lines were successful. There was no significant difference in procedure time between the three groups. However, incidence of insertional injuries was higher in CCVC group compared to PICC groups (p = 0.038). Ultrasound-guided PICC placement by a neurointensivist may be safe and feasible compared to fluoroscopy-guided PICC placement by interventional radiologists and CCVC placement for neurocritically ill patients.
format Online
Article
Text
id pubmed-6544252
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-65442522019-06-17 Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit Kim, Yong Oh Chung, Chi Ryang Gil, Eunmi Park, Chi-Min Suh, Gee Young Ryu, Jeong-Am PLoS One Research Article We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent central line placement and were admitted to the neurosurgical intensive care unit (ICU) between January 2014 and March 2018. In this study, the primary endpoint was central line-induced complications. The secondary endpoint was initial success of central line placement. Placements of ultrasound-guided PICC and CCVC performed at the bedside if intra-hospital transport was inappropriate. Other patients underwent PICC placement at the interventional radiology suite under fluoroscopic guidance. A total of 191 patients underwent central line placement in the neurosurgery ICU during the study period. Requirement for central line infusion (56.0%) and difficult venous access (28.8%) were the most common reasons for central line placement. The basilic vein (39.3%) and the subclavian vein (35.1%) were the most common target veins among patients who underwent central line placement. The placements of ultrasound-guided PICC and CCVC at the bedside were more frequently performed in patients on mechanical ventilation (p = 0.001) and with hemodynamic instability (p <0.001) compared to the fluoroscopy-guided PICC placement. The initial success rate of central line placement was better in the fluoroscopy-guided PICC placement than in the placements of ultrasound-guided PICC and CCVC at the bedside (p = 0.004). However, all re-inserted central lines were successful. There was no significant difference in procedure time between the three groups. However, incidence of insertional injuries was higher in CCVC group compared to PICC groups (p = 0.038). Ultrasound-guided PICC placement by a neurointensivist may be safe and feasible compared to fluoroscopy-guided PICC placement by interventional radiologists and CCVC placement for neurocritically ill patients. Public Library of Science 2019-05-31 /pmc/articles/PMC6544252/ /pubmed/31150465 http://dx.doi.org/10.1371/journal.pone.0217641 Text en © 2019 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Yong Oh
Chung, Chi Ryang
Gil, Eunmi
Park, Chi-Min
Suh, Gee Young
Ryu, Jeong-Am
Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title_full Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title_fullStr Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title_full_unstemmed Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title_short Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
title_sort safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544252/
https://www.ncbi.nlm.nih.gov/pubmed/31150465
http://dx.doi.org/10.1371/journal.pone.0217641
work_keys_str_mv AT kimyongoh safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit
AT chungchiryang safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit
AT gileunmi safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit
AT parkchimin safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit
AT suhgeeyoung safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit
AT ryujeongam safetyandfeasibilityofultrasoundguidedplacementofperipherallyinsertedcentralcatheterperformedbyneurointensivistinneurosurgeryintensivecareunit