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Comparison results of anxiety of patients between two groups. (a), (b), and (c) represented before intervention, after intervention, and SAS score, respectively. ∗Compared with control group, P<0.05.
Source publication
This study was aimed to explore the application value of ultrasound-guided peripherally inserted central catheter (PICC) combined with predictive nursing in the treatment of large-area severe burns. 88 patients with large-area severe burns who visited hospital were chosen as the research objects. They were randomly divided into the observation grou...
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Introduction: Prolonged antibiotic therapy is often recommended for the treatment of spinal infections. This study aimed to evaluate the efficacy and safety of outpatient intravenous (IV) antibiotic therapy for spinal neurosurgery patients with spondylodiscitis.
Methods: We carried out a retrospective study involving 67 patients who were administer...
Prolonged antibiotic therapy is often recommended for the treatment of spinal infections. This study aimed to evaluate the efficacy and safety of outpatient intravenous (IV) antibiotic therapy for spinal neurosurgery patients with spondylodiscitis. We carried out a retrospective study involving 67 patients who were administered peripherally inserte...
Background
Cancer indeed represents a significant public health challenge, and unplanned extubation of peripherally inserted central catheter (PICC-UE) is a critical concern in patient safety. Identifying independent risk factors and implementing high-quality assessment tools for early detection in high-risk populations can play a crucial role in r...
Citations
... Evidence rated as very low COE suggested that bundle intervention/multimodal strategies (ultrasound-guided insertion and occlusive dressing [42] or sterile insertion, chlorhexidine, insertion training, sterile gloves, and sterile access protocol [43]) may also decrease overall adverse events in adults compared with routine care (4.5% versus 18%; RR [95% CI], 0.22 [.05-.98]) [42]. One controlled-cohort study also reported fewer adverse events in neonates when a bundle/multimodal strategy was used (training, nighttime saline or heparin flushing, occlusive dressing; 7.8% vs 25.5%; RR [95% CI], .31 ...
... Evidence rated as very low COE suggested that bundle intervention/multimodal strategies (ultrasound-guided insertion and occlusive dressing [42] or sterile insertion, chlorhexidine, insertion training, sterile gloves, and sterile access protocol [43]) may also decrease overall adverse events in adults compared with routine care (4.5% versus 18%; RR [95% CI], 0.22 [.05-.98]) [42]. One controlled-cohort study also reported fewer adverse events in neonates when a bundle/multimodal strategy was used (training, nighttime saline or heparin flushing, occlusive dressing; 7.8% vs 25.5%; RR [95% CI], .31 ...
Background
Peripherally inserted central catheters (PICCs) have a 29% complication rate. This systematic review evaluated 25 interventions to prevent PICC-associated infectious and noninfectious complications in participants of all ages.
Methods
We searched electronic databases (MEDLINE, Embase, Cochrane Library, World Health Organization Global Index Medicus, CINAHL) and reference lists for randomized (RCTs) and nonrandomized controlled trials published between 1 January 1980-8 May 2024. We dually selected studies, assessed risk of bias, extracted data, and rated certainty of evidence (COE). We included single interventions of interest and combinations of at least 2 (bundle/multimodal). If 3 or more RCTs existed, we conducted Bayesian random-effects meta-analyses.
Results
Seventy-four studies met our eligibility criteria (60 evaluated single interventions, 14 bundle/multimodal), addressing 13 of 25 research questions. The majority were conducted in high-income countries; 36 focused on neonates. Evidence was very uncertain for 11 of the 13 research questions. Stronger COE showed that ultrasound-guided catheter insertion reduced phlebitis/thrombophlebitis in adults compared with non–ultrasound-guided (5 RCTs; risk ratio [RR], 0.19; 95% credible interval, .08–.50); silicone catheters increased phlebitis/thrombophlebitis compared with nonsilicone (1 RCT; RR, 2.00; 95% confidence interval [CI], 1.26–3.17). Bundle interventions decreased local infections (1 RCT; RR, 0.47; 95% CI, .31–.72) and phlebitis/thrombophlebitis in adults (1 RCT; RR, 0.35; 95% CI, .22–.56) compared with routine care.
Conclusions
Ultrasound-guided catheter insertion and nonsilicone catheters effectively prevented PICC complications. The evidence for other comparisons was too uncertain to draw conclusions, highlighting the urgent need for additional studies on prevention and control interventions.
... É uma tecnologia de fácil inserção (sem complicações relacionadas), manuseio e remoção simples, permitindo o uso em tratamentos prolongados 17 . Outro estudo também trouxe a aplicação clínica do PICC guiado por ultrassom e atuação da enfermagem em pacientes com queimaduras graves, enfatizando a redução de dor e satisfação 18 . ...
Background:
The placement of peripherally inserted central venous catheters (PICCs) has traditionally relied on measurements and anatomical landmarks. It involves post-placement chest X-rays (CXRs) and occasional repositioning, which incur additional direct and indirect costs, such as delays in care and staff time. The aim of this study was to assess the cost-effectiveness of a routine post-procedural CXR in the era of ultrasound and intracavitary electrocardiography (IC-ECG)-guided PICC insertion.
Methods:
A retrospective two-center study was conducted to review the clinical records of all patients who had PICCs in the Venous Access Center of Peking University Cancer Hospital & Institute and The Affiliated Qingdao Central Hospital of Qingdao University between 1 January 2019 and 30 June 2020. PICC placement was only available to patients who were 18 years or older, had in-sinus rhythm. The incidence of catheter misplacement after insertion was measured. Cavoatrial junction or the lower third of the superior vena cava (SVC) were defined as ideal catheter tip locations. A logistic regression analysis was performed to examine potential risk factors associated with PICC-related complications and a cost analysis was conducted to assess the economic impact of the use of CXR.
Results:
There were 2,863 samples from 2,653 patients included. The overall incidence of intraprocedural and primary catheter misplacement was 7.3% (n=210) and 0.70% (n=20), respectively. There was a high risk of primary catheter misplacement when the left-arm was chosen for placement [odds ratio (OR): 11.163; 95% confidence interval (CI): 3.720-33.495; P<0.001]. The overall cost of performing CXR for screening of PICC-related complications was 1,789.
Conclusions:
This study confirms that misplacement of PICCs guided by ultrasound and IC-ECG is rare and that postprocedural CXR is very costly. In our setting, routine postprocedural CXR is unnecessary especially when the PICC is catheterized in the right arm, and is not a wise option.
