PICC insertion by vascular surgeons
Abstract:
Objectives: This study analyzed the outcomes of the ultrasound-guided insertion of the peripherally inserted central venous catheter (PICC) by experienced vascular surgeons at the bedside of the trauma intensive care unit (ICU) and compared the outcomes with those of fluoroscopy-guided PICC performed by radiologists in the interventional suite.
Design: Retrospective observational study METHODS: : Between May 1, 2016, and April 30, 2021, 97 patients who were hospitalized in the trauma ICU and underwent PICC insertion were enrolled in the study. Forty-two out of the 97 patients underwent PICC insertion by interventional radiologists in the interventional radiology suite under fluoroscopy guidance, while the remaining 55 cases underwent ultrasound-guided PICC insertion by the vascular surgeon at the trauma ICU bedside.
Results: The technical failure (p = .504) and malposition (p = .127) rates were not significantly different between the two groups. However, it took significantly less time for the vascular surgeon to complete the PICC insertion procedure (p < .001). Significantly more patients of the ultrasound-guided group required inotropes (p = .012) and mechanical ventilation (p = .003) at the time of the procedure. In addition, the ultrasound-guided group appeared to be in critical condition in terms of kidney function according to laboratory data (p = .014). Meanwhile, the ultrasound-guided group maintained the central line catheter for a shorter time (p < .001).
Conclusions: In trauma patients, ultrasound-guided PICC insertion at the bedside by experienced vascular surgeons at the trauma ICU was feasible compared to fluoroscopy-guided insertion performed by interventional radiologists.
Reference:
Choi K, Keum MA, Kim MS, Kim Y, Choi S, Kyoung KH, Kim JT, Kim S, Noh M. Feasibility of the ultrasound-guided insertion of the peripherally inserted central catheter (PICC) by the vascular surgeon at the bedside in the trauma intensive care unit. Ann Vasc Surg. 2021 Oct 21:S0890-5096(21)00746-9. doi: 10.1016/j.avsg.2021.08.038. Epub ahead of print. PMID: 34688877.