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Abstract

Introduzione: Sebbene ci siano differenti metodi per confermare il posizionamento della punta di un catetere venoso centrale, la radiografia del torace rappresenta la procedura più raccomandata, ma espone i pazienti a radiazioni, comporta ritardi nei trattamenti e permette di controllare la posizione della punta solo dopo la procedura di posizionamento del device vascolare. Scopo: Valutare l’efficacia del posizionamento dei cateteri venosi centrali ad inserzione periferica utilizzando un sistema integrato (ecoguidato – elettrocardiogramma intracavitario). Metodi: È stato condotto uno studio caso-controllo su un campione di 165 pazienti, a cui doveva essere posizionato un catetere venoso centrale ad inserzione periferica per l’esecuzione della chemioterapia. Il gruppo dei casi è composto da pazienti il cui dispositivo vascolare viene posizionato con il sistema integrato mentre nel gruppo di controllo la lunghezza viene stimata antropometricamente, prima del posizionamento. La radiografia del torace è stata eseguita in entrambi i gruppi di soggetti arruolati. Risultati: Nessun caso di malposizionamento primario è stato registrato utilizzando il sistema integrato per il posizionamento degli accessi venosi centrali ad inserzione periferica. Le punte dei dispositivi erano tutte ben posizionate e nel 92% (n = 101) la localizzazione intra-procedurale della punta è risultata sovrapponibile a quella identificata nella radiografia del torace. Conclusione: Utilizzare un sistema integrato per il posizionamento dei dispositivi venosi centrali ad inserzione periferica permette di verificare e confermare la localizzazione della punta durante la procedura di posizionamento, evitando malposizionamenti primari. Elimina anche la necessità di eseguire la radiografia del torace, riducendo i costi e il tempo per i professionisti sanitari e gli assistiti.

Parole chiave

intracavitary electrocardiogram peripherally inserted central catheter line insertion ultrasound guide nursing elettrocardiogramma intracavitario PICC atetere venoso centrale ad inserzione periferica infermieristica

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Fiorini, J., Venturini, G., Colella, S., Adamo, M., Zaghini, F., Moureau, N., Conti, F., & Sili, A. (2020). Un Sistema Integrato per il corretto posizionamento della punta di un Catetere venoso Centrale ad Inserzione Periferica nei pazienti oncologici ed ematologici. PROFESSIONI INFERMIERISTICHE, 73(3). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/805
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