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Chest Radiograph Measurement Technique Facilitates Accurate Bedside Peripherally Inserted Central Catheter Placement in Children.

Abstract：

PURPOSE:To report the chest radiograph measurement technique for placing bedside peripherally inserted central catheters (PICCs). MATERIALS AND METHODS:Two hundred and thirty-two consecutive pediatric patients, mean age of 56.3 months (range: 0-203 months), underwent PICC placement from January 2015 to May 2017 (28 months) with a total of 232 PICCs placed. Measurements were taken from the cavoatrial junction to clavicle, clavicle to medial margin of mid-humeral head, and medial margin of mid-humeral head to mid-humerus. The difference between total radiographic measured length and actual PICC length was then calculated, and the percent difference (from actual cut length) was recorded. An equivalence test was performed using the two, one-sided test method. RESULTS:Mean ± standard deviation cavoatrial junction to clavicle length was 5.29 ± 2.20 cm (range: 2.1-12.6 cm). Mean clavicle to shoulder length was 8.20 ± 3.59 cm (range: 3.23-19.06 cm). Mean shoulder to mid-humerus length was 7.88 ± 3.87 cm (range: 2.01-16.8 cm). Mean total radiographic measured length was 21.37 ± 9.19 cm (range: 7.42-43.6 cm). Mean actual cut PICC length was 20.64 ± 8.72 cm (range: 8.5-44 cm). The mean difference between predicted, or total radiographic measured length, and actual cut PICC length was 0.73 ± 2.51 (range: - 5.42-8.60 cm). The mean percent difference was 4.07 ± 12.65% (range: - 23.84-47.80%). An equivalence test rejected the null hypothesis of the true percent difference greater/less than ± 6.67% with a p value of 0.002. CONCLUSION:The chest radiograph measurement technique is an accurate method to determine catheter length for PICC placement at bedside in the pediatric population.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

Ramamurthi A,Chick JFB,Srinivasa RN,Hage AN,Grove JJ,Gemmete JJ,Johnson TD,Srinivasa RN

doi

10.1007/s00270-017-1857-0

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

443-448

issue

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-017-1857-0

journal_volume

pub_type

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Chest Radiograph Measurement Technique Facilitates Accurate Bedside Peripherally Inserted Central Catheter Placement in Children.