Power injectable peripherally inserted central venous catheters (PICC) flip after power injection

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Intravenous literature: Lozano, L.A., Marn, C. and Goodman, L.R. (2012) Power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast. Journal of Computer Assisted Tomography. 36(4), p.427-30.

Abstract:

OBJECTIVE: To determine the frequency of power injectable peripherally inserted central venous catheter (PIPICC) displacement after contrast injection for computed tomography.

MATERIALS AND METHODS: We included all patients who had a computed tomographic examination with contrast administration via PIPICC over a 4-month period. Several variables including catheter location before and after the injection were documented. Descriptive statistics were used for continuous variables. The χ test was used to compare groups. Continuous variables were analyzed using the Student t test.

RESULTS: Among 78 injections in 67 patients (34 men and 33 women; median age, 49 years), there were 12 catheter displacements (15.4%): 5 (62.5%) of 8 catheters initially located proximal to the tracheobronquial angle (TBA) and 7 (10.14%) of 69 catheters initially located distal to the TBA. The initial catheter position before the injection correlated with the frequency of displacement significantly (P < 0.006). Contrast injection rate and amount of contrast were no risk factors for position change. There were no complications.

CONCLUSION: Catheter displacement occurred in 62.5%, with PIPICCS cephalad to the TBA. A preliminary scout view should be checked before the contrast injection. In addition, a postinjection scan scout view is recommended to verify catheter position.

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