Contenuto dell'articolo principale
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
Dettagli dell'articolo
Riferimenti
- Baldinelli, F., Capozzoli, G., Pedrazzoli, R., & Marzano, N. (2015). Evaluation of the correct position of peripherally inserted central catheters: Anatomical landmark vs. electrocardiographic technique. Journal of Vascular Access, 16(5), 394–398. https://doi.org/10.5301/jva.5000431
- Bidgood, C. (2016). Improving the patient experience with real-time PICC placement confirmation. British Journal of Nursing, 25(10), 539–543. https://doi.org/10.12968 /bjon.2016.25.10.539
- Calabrese, M., Montini, L., Arlotta, G., La Greca, A., Biasucci, D. G., Bevilacqua, F., … Pittiruti, M. (2019). A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients. The Journal of Vascular Access, 20(5), 516–523. https://doi.org/10.1177/1129729818819422
- Dale, M., Higgins, A., & Carolan-Rees, G. (2016). Sherlock 3CG® Tip Confirmation System for Placement of Peripherally Inserted Central Catheters: A NICE Medical Technology Guidance. Applied Health Economics and Health Policy, 14(1), 41–49. https://doi.org/10.1007/s40258-015-0192-3
- Gao, Y., Liu, Y., Zhang, H., Fang, F., & Song, L. (2018). The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation. Therapeutics and Clinical Risk Management, Volume 14, 1075–1081. https://doi.org/10.2147/TCRM.S156468
- Glauser, F., Breault, S., Rigamonti, F., Sotiriadis, C., Jouannic, A. M., & Qanadli, S. D. (2017). Tip malposition of peripherally inserted central catheters: a prospective randomized controlled trial to compare bedside insertion to fluoroscopically guided placement. European Radiology, 27(7), 2843–2849. https://doi.org/10.1007/s00330-016-4666-y
- Hamilton, H. (2006). Complications associated with venous access devices : part two. Nursing Standard, 20(27), 59–66.
- Infusion Nurses Society. (2016). The 2016 Infusion Therapy Standards of Practice. In Journal of Infusion Nursing (Vol. 39). https://doi.org/10.1097/NHH.0000000000000481
- Jeon, E. Y., Koh, S. H., Lee, I. J., Ha, H. Il, & Park, B. J. (2015). Useful equation for proper estimate of left side peripherally inserted central venous catheter length in relation to the height. Journal of Vascular Access, 16(1), 42–46. https://doi.org/10.5301/jva.5000309
- Jeon, Y., Ryu, H. G., Yoon, S. Z., Kim, J. H., & Bahk, J. H. (2006). Transesophageal echocardiographic evaluation of ECG-guided central venous catheter placement. Canadian Journal of Anesthesia, 53(10), 978–983. https://doi.org/10.1007/ BF03022525
- Johnston, A. J., Holder, A., Bishop, S. M., See, T. C., & Streater, C. T. (2014). Evaluation of the Sherlock 3CG tip confirmation system on peripherally inserted central catheter malposition rates. Anaesthesia, 69(12), 1322–1330. https://doi.org/10.1111/anae.12785
- Kang, S., Shin, Y., Lee, S., & Kim, H. (2018). Simplified equation for determining proper depth of peripherally inserted central catheter in relation to anatomical landmarks. Korean J Anesthesiol, 71(4), 300–304.
- Kwon, H. J., Jeong, Y. Il, Jun, I. G., Moon, Y. J., & Lee, Y. M. (2018). Evaluation of a central venous catheter tip placement for superior vena cava-subclavian central venous catheterization using a premeasured length. Medicine (United States), 97(2), 1–4. https://doi.org/10.1097/MD.000000000 0009600
- Lamperti, M., Bodenham, A. R., Pittiruti, M., Blaivas, M., Augoustides, J. G., Elbarbary, M., … Verghese, S. T. (2012). International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Medicine, 38(7), 1105–1117. https://doi.org/10.1007/s00134-012-2597-x
- Lelkes, V., Kumar, A., Shukla, P. A., Contractor, S., & Rutan, T. (2013). Analysis of the Sherlock II tip location system for inserting peripherally inserted central venous catheters. Clinical Imaging, 37(5), 917–921. https://doi.org/10.1016/ j.clinimag.2013.04.009
- Li, A., Jiao, J., Zhang, Y., Tan, L., Miao, J., Hao, X., … Sun, Q. (2018). A randomized controlled study of bedside electrocardiograph-guided tip location technique & the traditional chest radiography tip location technique for peripherally inserted central venous catheter in cancer patients. Indian J Med Res, 147(5), 477–483. https://doi.org/10.4103/ijmr.IJMR
- Li, W., Xu, R., & Fan, D. (2018). Clinical application of electrocardiogram-guided tip positioning in peripheral inserted central catheters placement. Journal of Cancer Research and Therapeutics, 14(4), 887. https://doi.org/10.4103/ jcrt.JCRT_46_18
- Liu, Gao, Fu, Z.-Q., Zhu, P., & Li, S.-J. (2015). Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors. Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban, 35(3), 445–449. https://doi.org/10.1007/s11596-015-1451-0
- Liu, Guang, Hou, W., Zhou, C., Yin, Y., Lu, S., Duan, C., … Zhang, H. (2019). Meta-analysis of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement. Journal of Vascular Access. https://doi.org/10.1177/1129729819826028
- Lum, P. (2004). A New Formula-Based Measurement Guide for Optimal Positioning of Central Venous Catheters. Journal of the Association for Vascular Access, 9(2), 80–85. https://doi.org/10.2309/155288504774654928
- Minkovich, L., Djaiani, G., McCluskey, S. A., Mitsakakis, N., Gilbert, R. W., & Beattie, W. S. (2011). Frequent malpositions of peripherally inserted central venous catheters in patients undergoing head and neck surgery. Canadian Journal of Anesthesia, 58(8), 709–713. https://doi.org/10.1007 /s12630-011-9512-8
- Monard, C., Lefèvre, M., Subtil, F., Piriou, V., & David, J.-S. (2018). Peripherally inserted central catheter with intracavitary electrocardiogram guidance: Malposition risk factors and indications for post-procedural control. The Journal of Vascular Access, 112972981878126. https://doi.org/10.1177/1129729818781266
- Moureau, N. L., & Chopra, V. (2016). Indications for peripheral, midline and central catheters: summary of the MAGIC recommendations. British Journal of Nursing, 25(8), S15–S24.
- Moureau, N. L., Dennis, G. L., Ames, E., & Severe, R. (2010). Electrocardiogram (EKG) Guided Peripherally Inserted Central Catheter Placement and Tip Position: Results of a Trial to Replace Radiological Confirmation. Journal of the Association for Vascular Access, 15(1), 8–14. https://doi.org/ 10.2309/java.15-1-3
- Nichols, I., & Humphrey, J. P. (2008). The efficacy of upper arm placement of peripherally inserted central catheters using bedside ultrasound and microintroducer technique. Journal of Infusion Nursing, 31(3), 165–176. https://doi.org/10.1097/ 01.NAN.0000317703.66395.b8
- Nolan, M. E., Yadav, H., Cawcutt, K. A., & Cartin-Ceba, R. (2016). Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit. Journal of Critical Care, 31(1), 238–242. https://doi.org/10.1016/j.jcrc.2015.09.024
- Oliver, G., & Jones, M. (2016). ECG-based PICC tip verification system: an evaluation 5 years on. British Journal of Nursing, 25(19), S4–S10. https://doi.org/10.12968/bjon.2016.25. 19.s4
- Ping, D., Peiyi, H., Meiqing, H., Xingwei, Y., & Meihong, D. (2008). Comparison of Two Different External Measurement Methods of PICC. Journal of Nursing Science, 2.
- Pittiruti, M., Bertollo, D., Briglia, E., Buononato, M., Capozzoli, G., De Simone, L., … Sette, P. S. (2012). The intracavitary ECG method for positioning the tip of central venous catheters: Results of an Italian multicenter study. Journal of Vascular Access, 13(3), 357–365. https://doi.org/10.5301/ JVA.2012.9020
- Pittiruti, M., La Greca, A., & Scoppettuolo, G. (2011). The electrocardiographic method for positioning the tip of central venous catheters. Journal of Vascular Access, 12(4), 280–291. https://doi.org/10.5301/JVA.2011.8381
- Pittiruti, M., Scoppettuolo, G., Dolcetti, L., & Emoli, A. (2018). Clinical use of Sherlock-3CG ® for positioning peripherally inserted central catheters. The Journal of Vascular Access, 112972981880595. https://doi.org/10.1177/1129729818 805957
- Spina, R., Mussa, B., Tollapi, L., Conti, F., Cortesi, E., & Verna, R. (2018). Adoption and application in Italy of the principal guidelines and international recommendations on venous access. Minerva Medica, 109(3), 153–202. https://doi.org/10.23736/S0026-4806.18.05552-0
- Stonelake, P. A., & Bodenham, A. R. (2006). The carina as a radiological landmark for central venous catheter tip position. British Journal of Anaesthesia, 96(3), 335–340. https://doi.org/10.1093/bja/aei310
- Tomaszewski, K. J., Ferko, N., Hollmann, S. S., Eng, S. C., Richard, H. M., Rowe, L., & Sproule, S. (2017). Time and resources of peripherally inserted central catheter insertion procedures: A comparison between blind insertion/chest X-ray and a real time tip navigation and confirmation system. ClinicoEconomics and Outcomes Research, 9, 115–125. https://doi.org/10.2147/CEOR.S121230
- Yin, Y.-X., Gao, W., Li, X.-Y., Lu, W., Deng, Q.-H., Zhao, C.-Y., … Zhang, H.-J. (2018). Insertion of peripherally inserted central catheters with intracavitary electrocardiogram guidance: A randomized multicenter study in China. The Journal of Vascular Access, 1–6. https://doi.org/10.1177/
- Yuan, L., Li, R., Meng, A., Feng, Y., Wu, X., Yang, Y., … Xu, W. (2017). Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: A randomized openlabel controlled multicenter study. PLoS ONE, 12(3), 1–12. https://doi.org/10.1371/journal.pone.0171630
- Zhang, X., Jia, D., Ke, N., Liu, C., Fu, L., & Hu, X. (2018). Excellent inter-observer agreement between radiologist and nurse: Tracheal carina-based identification of peripherally inserted central catheter tip position. Journal of Vascular Access, 19(1), 28–33. https://doi.org/10.5301/jva.5000799
- Zhang, X., Ke, N., Liu, C., Hu, X., Yu, H., & Jia, Y. (2016). Bedside prediction of peripherally inserted central catheter length: Based on patient height combined with surface landmark. International Journal of Clinical and Experimental Medicine, 9(8), 15928–15934
Riferimenti
Baldinelli, F., Capozzoli, G., Pedrazzoli, R., & Marzano, N. (2015). Evaluation of the correct position of peripherally inserted central catheters: Anatomical landmark vs. electrocardiographic technique. Journal of Vascular Access, 16(5), 394–398. https://doi.org/10.5301/jva.5000431
Bidgood, C. (2016). Improving the patient experience with real-time PICC placement confirmation. British Journal of Nursing, 25(10), 539–543. https://doi.org/10.12968 /bjon.2016.25.10.539
Calabrese, M., Montini, L., Arlotta, G., La Greca, A., Biasucci, D. G., Bevilacqua, F., … Pittiruti, M. (2019). A modified intracavitary electrocardiographic method for detecting the location of the tip of central venous catheters in atrial fibrillation patients. The Journal of Vascular Access, 20(5), 516–523. https://doi.org/10.1177/1129729818819422
Dale, M., Higgins, A., & Carolan-Rees, G. (2016). Sherlock 3CG® Tip Confirmation System for Placement of Peripherally Inserted Central Catheters: A NICE Medical Technology Guidance. Applied Health Economics and Health Policy, 14(1), 41–49. https://doi.org/10.1007/s40258-015-0192-3
Gao, Y., Liu, Y., Zhang, H., Fang, F., & Song, L. (2018). The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation. Therapeutics and Clinical Risk Management, Volume 14, 1075–1081. https://doi.org/10.2147/TCRM.S156468
Glauser, F., Breault, S., Rigamonti, F., Sotiriadis, C., Jouannic, A. M., & Qanadli, S. D. (2017). Tip malposition of peripherally inserted central catheters: a prospective randomized controlled trial to compare bedside insertion to fluoroscopically guided placement. European Radiology, 27(7), 2843–2849. https://doi.org/10.1007/s00330-016-4666-y
Hamilton, H. (2006). Complications associated with venous access devices : part two. Nursing Standard, 20(27), 59–66.
Infusion Nurses Society. (2016). The 2016 Infusion Therapy Standards of Practice. In Journal of Infusion Nursing (Vol. 39). https://doi.org/10.1097/NHH.0000000000000481
Jeon, E. Y., Koh, S. H., Lee, I. J., Ha, H. Il, & Park, B. J. (2015). Useful equation for proper estimate of left side peripherally inserted central venous catheter length in relation to the height. Journal of Vascular Access, 16(1), 42–46. https://doi.org/10.5301/jva.5000309
Jeon, Y., Ryu, H. G., Yoon, S. Z., Kim, J. H., & Bahk, J. H. (2006). Transesophageal echocardiographic evaluation of ECG-guided central venous catheter placement. Canadian Journal of Anesthesia, 53(10), 978–983. https://doi.org/10.1007/ BF03022525
Johnston, A. J., Holder, A., Bishop, S. M., See, T. C., & Streater, C. T. (2014). Evaluation of the Sherlock 3CG tip confirmation system on peripherally inserted central catheter malposition rates. Anaesthesia, 69(12), 1322–1330. https://doi.org/10.1111/anae.12785
Kang, S., Shin, Y., Lee, S., & Kim, H. (2018). Simplified equation for determining proper depth of peripherally inserted central catheter in relation to anatomical landmarks. Korean J Anesthesiol, 71(4), 300–304.
Kwon, H. J., Jeong, Y. Il, Jun, I. G., Moon, Y. J., & Lee, Y. M. (2018). Evaluation of a central venous catheter tip placement for superior vena cava-subclavian central venous catheterization using a premeasured length. Medicine (United States), 97(2), 1–4. https://doi.org/10.1097/MD.000000000 0009600
Lamperti, M., Bodenham, A. R., Pittiruti, M., Blaivas, M., Augoustides, J. G., Elbarbary, M., … Verghese, S. T. (2012). International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Medicine, 38(7), 1105–1117. https://doi.org/10.1007/s00134-012-2597-x
Lelkes, V., Kumar, A., Shukla, P. A., Contractor, S., & Rutan, T. (2013). Analysis of the Sherlock II tip location system for inserting peripherally inserted central venous catheters. Clinical Imaging, 37(5), 917–921. https://doi.org/10.1016/ j.clinimag.2013.04.009
Li, A., Jiao, J., Zhang, Y., Tan, L., Miao, J., Hao, X., … Sun, Q. (2018). A randomized controlled study of bedside electrocardiograph-guided tip location technique & the traditional chest radiography tip location technique for peripherally inserted central venous catheter in cancer patients. Indian J Med Res, 147(5), 477–483. https://doi.org/10.4103/ijmr.IJMR
Li, W., Xu, R., & Fan, D. (2018). Clinical application of electrocardiogram-guided tip positioning in peripheral inserted central catheters placement. Journal of Cancer Research and Therapeutics, 14(4), 887. https://doi.org/10.4103/ jcrt.JCRT_46_18
Liu, Gao, Fu, Z.-Q., Zhu, P., & Li, S.-J. (2015). Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors. Journal of Huazhong University of Science and Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban, 35(3), 445–449. https://doi.org/10.1007/s11596-015-1451-0
Liu, Guang, Hou, W., Zhou, C., Yin, Y., Lu, S., Duan, C., … Zhang, H. (2019). Meta-analysis of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement. Journal of Vascular Access. https://doi.org/10.1177/1129729819826028
Lum, P. (2004). A New Formula-Based Measurement Guide for Optimal Positioning of Central Venous Catheters. Journal of the Association for Vascular Access, 9(2), 80–85. https://doi.org/10.2309/155288504774654928
Minkovich, L., Djaiani, G., McCluskey, S. A., Mitsakakis, N., Gilbert, R. W., & Beattie, W. S. (2011). Frequent malpositions of peripherally inserted central venous catheters in patients undergoing head and neck surgery. Canadian Journal of Anesthesia, 58(8), 709–713. https://doi.org/10.1007 /s12630-011-9512-8
Monard, C., Lefèvre, M., Subtil, F., Piriou, V., & David, J.-S. (2018). Peripherally inserted central catheter with intracavitary electrocardiogram guidance: Malposition risk factors and indications for post-procedural control. The Journal of Vascular Access, 112972981878126. https://doi.org/10.1177/1129729818781266
Moureau, N. L., & Chopra, V. (2016). Indications for peripheral, midline and central catheters: summary of the MAGIC recommendations. British Journal of Nursing, 25(8), S15–S24.
Moureau, N. L., Dennis, G. L., Ames, E., & Severe, R. (2010). Electrocardiogram (EKG) Guided Peripherally Inserted Central Catheter Placement and Tip Position: Results of a Trial to Replace Radiological Confirmation. Journal of the Association for Vascular Access, 15(1), 8–14. https://doi.org/ 10.2309/java.15-1-3
Nichols, I., & Humphrey, J. P. (2008). The efficacy of upper arm placement of peripherally inserted central catheters using bedside ultrasound and microintroducer technique. Journal of Infusion Nursing, 31(3), 165–176. https://doi.org/10.1097/ 01.NAN.0000317703.66395.b8
Nolan, M. E., Yadav, H., Cawcutt, K. A., & Cartin-Ceba, R. (2016). Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit. Journal of Critical Care, 31(1), 238–242. https://doi.org/10.1016/j.jcrc.2015.09.024
Oliver, G., & Jones, M. (2016). ECG-based PICC tip verification system: an evaluation 5 years on. British Journal of Nursing, 25(19), S4–S10. https://doi.org/10.12968/bjon.2016.25. 19.s4
Ping, D., Peiyi, H., Meiqing, H., Xingwei, Y., & Meihong, D. (2008). Comparison of Two Different External Measurement Methods of PICC. Journal of Nursing Science, 2.
Pittiruti, M., Bertollo, D., Briglia, E., Buononato, M., Capozzoli, G., De Simone, L., … Sette, P. S. (2012). The intracavitary ECG method for positioning the tip of central venous catheters: Results of an Italian multicenter study. Journal of Vascular Access, 13(3), 357–365. https://doi.org/10.5301/ JVA.2012.9020
Pittiruti, M., La Greca, A., & Scoppettuolo, G. (2011). The electrocardiographic method for positioning the tip of central venous catheters. Journal of Vascular Access, 12(4), 280–291. https://doi.org/10.5301/JVA.2011.8381
Pittiruti, M., Scoppettuolo, G., Dolcetti, L., & Emoli, A. (2018). Clinical use of Sherlock-3CG ® for positioning peripherally inserted central catheters. The Journal of Vascular Access, 112972981880595. https://doi.org/10.1177/1129729818 805957
Spina, R., Mussa, B., Tollapi, L., Conti, F., Cortesi, E., & Verna, R. (2018). Adoption and application in Italy of the principal guidelines and international recommendations on venous access. Minerva Medica, 109(3), 153–202. https://doi.org/10.23736/S0026-4806.18.05552-0
Stonelake, P. A., & Bodenham, A. R. (2006). The carina as a radiological landmark for central venous catheter tip position. British Journal of Anaesthesia, 96(3), 335–340. https://doi.org/10.1093/bja/aei310
Tomaszewski, K. J., Ferko, N., Hollmann, S. S., Eng, S. C., Richard, H. M., Rowe, L., & Sproule, S. (2017). Time and resources of peripherally inserted central catheter insertion procedures: A comparison between blind insertion/chest X-ray and a real time tip navigation and confirmation system. ClinicoEconomics and Outcomes Research, 9, 115–125. https://doi.org/10.2147/CEOR.S121230
Yin, Y.-X., Gao, W., Li, X.-Y., Lu, W., Deng, Q.-H., Zhao, C.-Y., … Zhang, H.-J. (2018). Insertion of peripherally inserted central catheters with intracavitary electrocardiogram guidance: A randomized multicenter study in China. The Journal of Vascular Access, 1–6. https://doi.org/10.1177/
Yuan, L., Li, R., Meng, A., Feng, Y., Wu, X., Yang, Y., … Xu, W. (2017). Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: A randomized openlabel controlled multicenter study. PLoS ONE, 12(3), 1–12. https://doi.org/10.1371/journal.pone.0171630
Zhang, X., Jia, D., Ke, N., Liu, C., Fu, L., & Hu, X. (2018). Excellent inter-observer agreement between radiologist and nurse: Tracheal carina-based identification of peripherally inserted central catheter tip position. Journal of Vascular Access, 19(1), 28–33. https://doi.org/10.5301/jva.5000799
Zhang, X., Ke, N., Liu, C., Hu, X., Yu, H., & Jia, Y. (2016). Bedside prediction of peripherally inserted central catheter length: Based on patient height combined with surface landmark. International Journal of Clinical and Experimental Medicine, 9(8), 15928–15934