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The impact of the use of new X-Ray technology to ensure the best placement of catheters
LUZ,C.C.; SANTOS,J.L.S.;LASELVA,C.R.;SILVA,V.C
Albert Einstein Hospital
Abstract
Methods
Results
The best results in relation to the maintenance
and improvement of helpful life of the catheters,
are related to the initial placement of the same.
In Brazil, we do not have technology already sold
in the market to ensure the placement of
catheters, as Sherlock and Vasonova TPS.
In our service we have available mobile RX (XRD),
portable, allowing us the end of the procedure,
observe the image of the positioning of the
catheter at the bedside, thus ensuring proper
positioning of the catheter to the patient's safety
and procedure . With this, we are reducing the
complications that comes from improper
positioning, particularly thrombosis.
Comparative retrospective study between the period of January
and February 2013 and January and February 2014, on the use
of conventional XR versus XR portable XRD-Carestream DRX-1
system, for placement of peripherally inserted central catheter
(PICC). 324 insertions were evaluated in 2013, and 332 insertions
in 2014. Data were collected in a hospital considered large, with
approximately 800 beds, tertiary care, in Sao Paulo, Brasil.
We managed to reduce the time from assessment until
release of the catheter in 1 hour. (There was 2 hours and
now is 1 hour).
Catheter´s bad position rates improved.
There was an increase in the success rate of PICC
placement in the Superior Vena Cava 82.20% (January and
February 2013) to 90.10% (January-February 2014)
average, which represents an increase of 7.90 % in this
rate.
SUCCESS RATE
% of PICC line placement in SCV
85%
Objective
•To evaluate the position of the PICC line,
immediately after insertion.
•To solve the malposition immediately after
detection.
•To reduce the total procedure time.
•To esure that medications are administered
immediately after the procedure.
•To reduce rates of adverse events and poor
positioning.
•To reduce loss of materials for dressings
duplicate.
93%
95%
84%
86%
80%
75%
65%
2013
Janeiro
January
References
2014
Fevereiro
February
-Pittiruti M, The intracavitary ECG method for positioning the tip of central venous catheters: results of an Italian
Conclusions
multicenter study. J Vasc Access. 2012 Jul-Sep;13(3):357-65.
-Katheria AC, A randomized controlled trial of ultrasound-guided peripherally inserted central catheters compared
with standard radiograph in neonates. J Perinatol. 2013 Oct;33(10):791-4.
-Roberto P. Central venous line placement is not compromised by the choice between different insertion
sites. Study performed in cardiovascular surgery patient. Rev Port Cir Cardiotorac Vasc. 2013 Jan-Mar;20(1):13-7
The use of new technology for radiological confirmation - DRX
has a positive impact on the success rate of PICC line placement,
improving Catheter´s bad position rates.