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논문 기본 정보

자료유형
학술저널
저자정보
정용채 (충남대학교병원) 심만식 (충남대학교병원 흉부외과) 박희선 (충남대학교) 강민웅 (충남대학교)
저널정보
대한중환자의학회 Acute and Critical Care Acute and Critical Care Vol.39 No.2
발행연도
2024.5
수록면
266 - 274 (9page)
DOI
10.4266/acc.2024.00150

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초록· 키워드

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Background: Although guidelines and protocols are available for central venous access, existing methods lack specificity and sensitivity, especially when placing peripherally inserted central catheters (PICCs). We evaluated the feasibility of catheter detection in the right atrial cavity using transthoracic echocardiography (TTE) during PICC placement.Methods: This single-center, retrospective study included consecutive patients who underwent PICC placement between January 2022 and March 2023. TTE was performed to detect the arrival of the catheter in the right atrial cavity. Catheter misplacement was defined as an aberrant catheter position on chest x-ray (CXR). The primary endpoint was predicting catheter misplacement based on catheter detection in the right atrial cavity. The secondary endpoint was optimizing catheter placement and examining catheter-associated complications.Results: Of the 110 patients identified, 10 were excluded because of poor echogenicity and vein access failure. The remaining 100 patients underwent PICC placement with TTE. The catheter was visualized in the right atrial cavity in 90 patients. CXR exams revealed catheter misplacement in seven cases. Eight patients with catheter misplacement underwent the same procedure in the other arm. In two patients, PICC placement failed due to anatomical reasons. Catheter misplacement was detected using TTE with sensitivity, specificity, positive predictive value, and negative predictive value of 97% confidence interval (CI, 91.31%–99.36%), 90% CI (55.50%–99.75%), 99%, and 75%, respectively.Conclusions: TTE is a reliable tool for detecting catheter misplacement and optimizing catheter tip positioning during PICC placement.

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