| Abstract: | Objective To compare the feasibility, complications, mid- and long-term advantages of peripherally inserted central venous catheters (PICC) and traditional central venous catheter (CVC) access assisted with X-ray image. Methods From 1997 to 1998, we conducted a study including 60 patients placed PICC lines and 60 patients placed CVC lines. Study variables included tip sites and complication rates.Results The result of the study assisted with X-ray image showed that 95% of total PICC placements was successful in surgical patients. The mean duration for PICC catheters placed before removal was 13 days (6-98 days) and fifty-three catheters (88.3%) were removed following completion of therapy. The total occlusion rate was 6.7% (4/60), and occlusion rate in 3 Fr (20-gauge) catheters (3/20, 15%) was higher than in 4 Fr (18-gauge) catheters (1/20, 5%). Phlebitis occurred in 5% of patients(3/60) and one catheter fracture happened on the catheter-hub junction (1.7%). The catheter tip dislocation occurred in 3 cases with PICC (3/60, 5%) and was moved to the optional position assisted with X-ray image. In CVC group, the total successful placement was 88% and the mean duration was 14 days(7-104 days). Pneumothorax happened in 1 case (1.7%). The catheters were withdrawn in 4 catheter dislocation cases. No catheter-related sepsis and hemopneumothorax happened in both two groups.Conclusions PICC assisted with X-ray image has advantages of less trauma and accurate localization, which could avoided many severe complications of central venous access such as pnemothorax. The new method provides a reliable and effective venous access that could satisfy mid- and long-term treatment in the patients receiving a variety of solutions, primarily parenteral nutrition, chemotherapy or antibiotic infusion. |
