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. 2018 May-Jun;26(3):206-210.
doi: 10.1590/1413-785220182603189368.

PERIPHERALLY INSERTED CENTRAL CATHETERS IN ORTHOPEDIC PATIENTS: EXPERIENCE FROM 1023 PROCEDURES

Thais Queiroz Santolim  1 , André Mathias Baptista  2 , Arlete Mazzini Miranda Giovani  1 , Juan Pablo Zumárraga  2 , Olavo Pires DE Camargo  2   3
Affiliations

PERIPHERALLY INSERTED CENTRAL CATHETERS IN ORTHOPEDIC PATIENTS: EXPERIENCE FROM 1023 PROCEDURES

Thais Queiroz Santolim et al. Acta Ortop Bras. 2018 May-Jun.

Abstract
in English, Portuguese

Objectives: The advantages of using a peripherally inserted central catheter (PICC) in hospitalized patients make this device very important for intravenous therapy. This study describes the use of PICCs at the Institute of Orthopedics and Traumatology at the Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo over the last 10 years.

Methods: This retrospective study analyzed 1,057 medical records and included 1,023 medical files with complete information on the punctured vein, diagnosis, duration of catheterization, complications, and catheter tip positioning.

Results: Seven hundred and twenty PICCs (70.4%) were considered successfully positioned, and mean duration of catheterization was 34.3 days. The basilic vein was used in 528 (51.6%) patients, while 157 (15.4%) catheters were removed due to complications. No cases of catheter-related thrombosis or infection were found. Eight hundred and sixty-six (84.6%) patients completed their treatment with PICC in place.

Conclusion: PICC is a safe intravenous device that can be successfully utilized for medium- and long-course intravenous therapy in hospitalized and discharged orthopedic patients. Level of Evidence IV; Case series.

Objetivos: As vantagens da utilização do Cateter Central de Inserção Periférica (CCIP) no ambiente hospitalar faz com que esse cateter ocupe uma posição de destaque na terapia intravenosa. Este trabalho relata o uso do CCIP nos pacientes do Instituto de Ortopedia e Traumatologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HC-FMUSP) nos últimos 10 anos.

Métodos: Trata-se de um estudo retrospectivo, no qual foram analisados 1057 prontuários. Foram incluídos 1023 prontuários de pacientes submetidos à inserção do CCIP, em que foram analisados a veia puncionada, diagnóstico do paciente, tempo em que o paciente permaneceu com o cateter, complicações e posicionamento da ponta do CCIP.

Resultados: Setecentos e vinte CCIPs (70,4%) foram considerados adequadamente posicionados. O tempo médio de utilização do cateter foi de 34,3 dias. A veia basílica foi a mais utilizada em 528 (51,6%) pacientes. Cento e cinquenta e sete (15,4%) cateteres foram removidos devido a complicações. Nenhum caso de trombose ou infecção relacionada ao cateter foi observada. Oitocentos e sessenta e seis (84,6%) permaneceram com o CCIP até o final do tratamento.

Conclusão: O CCIP é um dispositivo intravenoso seguro e pode ser utilizado para terapia intravenosa de média e longa duração em pacientes ortopédicos hospitalizados ou desospitalizados. Nível de Evidencia IV; Série de casos.

Keywords: Catheterization, central venous; Catheterization, peripheral; Infusions, intravenous; Nursing care.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Chest x-ray showing the tip of the PICC positioned in the subclavian vein.
Figure 2
Figure 2. Chest x-ray showing the tip of the PICC positioned in the superior vena cava.
Figure 3
Figure 3. Algorithm for intravenous device selection.
Figure 4
Figure 4. Measurements taken prior to procedure for proper positioning of the PICC
See this image and copyright information in PMC

References

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