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Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions

Received: 5 February 2020     Accepted: 17 February 2020     Published: 28 February 2020
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Abstract

Objective We analyze risk factors of ectopy of peripherally inserted central catheter tip in obese patients after weight reduction surgery and explore effective nursing interventions. Methods we conducted a retrospective analysis of the general data, PICC data, and position of catheter tip of 190 obese patients who had PICC for weight reduction surgery in our hospital from May 2018 to June 2019. We used monofactor and multi-factor logistic regression analysis to investigate the risk factors of peripherally inserted central catheter tip misplacement in obese patients who underwent weight reduction surgery. Results We found 29 cases (15.3%) of ectopy of PICC tip among which 13 cases of misplaced tips were found in internal jugular vein, 5 cases in subclavian vein, 4 cases in brachiocephalic veins, 4 cases in right atrium and 3 cases in axillary vein. The monofactor analysis showed that height, weight, BMI of patients, the vein, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the related risk factors of ectopy of PICC tip in obese patients who underwent weight reduction surgery. The multi-factor logistic regression analysis showed that BMI, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the independent risk factors of ectopy of PICC tip. Conclusions Since BMI, arm circumference and the cases of catheters the operators have inserted are the factors that may cause ectopy of PICC tip, we advise the operators should have good experience of inserting catheters and the cases of catheters they have inserted should be≥100; Besides, the location of the vein should be determined by ultrasound B before inserting, the length of catheters should be measured by two nurses, and the ectopy of catheter tip can be prevented and corrected by using ultrasonic probe to press the internal jugular vein.

Published in European Journal of Preventive Medicine (Volume 8, Issue 1)
DOI 10.11648/j.ejpm.20200801.12
Page(s) 7-11
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Obese Patients, Ectopy of Picc, Related Factors, Nursing Interventions

References
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[2] Ahuja, N. K, & Nimgaonkar, A. (2016). Precision bariatrics: toward a new paradigm of personalized devices in obesity therapeutics. Obesity Surgery, 26 (7), 1642-1645.
[3] Dillon, C, Peddle, J. Twells, L., Lester, K., & Gregory, D. (2015). Rapid reduction in use of antidiabetic medication after laparoscopic sleeve gastrectomy: the new found land and labrador bariatric surgery cohort (basco) study. The Canadian journal of hospital pharmacy, 68 (2), 113-120.
[4] Sheu, E. G., Channick, R., & Gee, D. W. (2016). Improvement in severe pulmonary hypertension in obese patients after laparoscopic gastric bypass or sleeve gastrectomy. Surgical Endoscopy, 30 (2), 633-637.
[5] J. J. Menéndez, C. Verdú, B. Calderón, A. Gómez-Zamora, C. Schüffelmann, & Cruz, J. J., et al. (2016). Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children. Journal of Thrombosis and Haemostasis, 14 (11), 2158-2168.
[6] Patel, S. R., Malhotra, A., White, D. P., Gottlieb, D. J., & Hu, F. B. (2006). Association between reduced sleep and weight gain in women. American Journal of Epidemiology, 164 (10), 947-954.
[7] Listed, N. A. (2008). Surgery for obesity in adults. Drug & Therapeutics Bulletin, 46 (6), 41-5.
[8] Zitsman, J. L., Digiorgi, M. F., Marr, J. R., Witt, M. A., & Bessler, M. (2011). Comparative outcomes of laparoscopic adjustable gastric banding in adolescents and adults. Surgery for Obesity and Related Diseases, 7 (6), 720-726.
[9] Colquitt, J. L., Pickett, K., Loveman, E., & Frampton, G. K. (2014). Surgery for weight loss in adults. Cohrane Database of Systematic Reviews, 8 (Issue 8 Art. No.: CD003641), CD003641.
[10] Kang, J. R., Long, L. H., Yan, S. W., Wei, W. W., Jun, H. Z., & Chen, W. (2017). Peripherally inserted central catheter-related vein thrombosis in patients with lung cancer. Clin Appl Thromb Hemost, 23 (2), 181-186.
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[12] Cotogni, P., Barbero, C., Garrino, C., Degiorgis, C., Mussa, B., & De Francesco, A., et al. (2015). Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study. Supportive Care in Cancer, 23 (2), 403-409.
[13] Cotogni, P., Pittiruti, M., Barbero, C., Monge, T., Palmo, A., & Boggio Bertinet, D. (2013). Catheter-related complications in cancer patients on home parenteral nutrition: a prospective study of over 51,000 catheter days. Journal of Parenteral and Enteral Nutrition, 37 (3), 375-383.
[14] Tracey L. Abitz. (2016). Cultural congruence and infusion nursing practice. Journal of Infusion Nursing the Official Publication of the Infusion Nurses Society, 39 (2), 75-79.
[15] Botella-Carretero, J. I., Carrero, C., Guerra, E., Valbuena, B., Arrieta, F., & Calanas, A., et al. (2013). Role of peripherally inserted central catheters in home parenteral nutrition: a 5-year prospective study. Journal of Parenteral and Enteral Nutrition, 37 (4), 544-549.
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[17] Line Dahlstrøm Christensen, Henrik Højgaard Rasmussen, & Vinter-Jensen, L. (2013). Peripherally inserted central catheter for use in home parenteral nutrition: a 4-year follow-up study. Journal of Parenteral and Enteral Nutrition, 38 (8), 1003-6.
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  • APA Style

    Li Qiufeng, Huang Guohua, He Jinai, Liu Yintian. (2020). Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions. European Journal of Preventive Medicine, 8(1), 7-11. https://doi.org/10.11648/j.ejpm.20200801.12

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    ACS Style

    Li Qiufeng; Huang Guohua; He Jinai; Liu Yintian. Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions. Eur. J. Prev. Med. 2020, 8(1), 7-11. doi: 10.11648/j.ejpm.20200801.12

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    AMA Style

    Li Qiufeng, Huang Guohua, He Jinai, Liu Yintian. Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions. Eur J Prev Med. 2020;8(1):7-11. doi: 10.11648/j.ejpm.20200801.12

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  • @article{10.11648/j.ejpm.20200801.12,
      author = {Li Qiufeng and Huang Guohua and He Jinai and Liu Yintian},
      title = {Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions},
      journal = {European Journal of Preventive Medicine},
      volume = {8},
      number = {1},
      pages = {7-11},
      doi = {10.11648/j.ejpm.20200801.12},
      url = {https://doi.org/10.11648/j.ejpm.20200801.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20200801.12},
      abstract = {Objective We analyze risk factors of ectopy of peripherally inserted central catheter tip in obese patients after weight reduction surgery and explore effective nursing interventions. Methods we conducted a retrospective analysis of the general data, PICC data, and position of catheter tip of 190 obese patients who had PICC for weight reduction surgery in our hospital from May 2018 to June 2019. We used monofactor and multi-factor logistic regression analysis to investigate the risk factors of peripherally inserted central catheter tip misplacement in obese patients who underwent weight reduction surgery. Results We found 29 cases (15.3%) of ectopy of PICC tip among which 13 cases of misplaced tips were found in internal jugular vein, 5 cases in subclavian vein, 4 cases in brachiocephalic veins, 4 cases in right atrium and 3 cases in axillary vein. The monofactor analysis showed that height, weight, BMI of patients, the vein, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the related risk factors of ectopy of PICC tip in obese patients who underwent weight reduction surgery. The multi-factor logistic regression analysis showed that BMI, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the independent risk factors of ectopy of PICC tip. Conclusions Since BMI, arm circumference and the cases of catheters the operators have inserted are the factors that may cause ectopy of PICC tip, we advise the operators should have good experience of inserting catheters and the cases of catheters they have inserted should be≥100; Besides, the location of the vein should be determined by ultrasound B before inserting, the length of catheters should be measured by two nurses, and the ectopy of catheter tip can be prevented and corrected by using ultrasonic probe to press the internal jugular vein.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions
    AU  - Li Qiufeng
    AU  - Huang Guohua
    AU  - He Jinai
    AU  - Liu Yintian
    Y1  - 2020/02/28
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ejpm.20200801.12
    DO  - 10.11648/j.ejpm.20200801.12
    T2  - European Journal of Preventive Medicine
    JF  - European Journal of Preventive Medicine
    JO  - European Journal of Preventive Medicine
    SP  - 7
    EP  - 11
    PB  - Science Publishing Group
    SN  - 2330-8230
    UR  - https://doi.org/10.11648/j.ejpm.20200801.12
    AB  - Objective We analyze risk factors of ectopy of peripherally inserted central catheter tip in obese patients after weight reduction surgery and explore effective nursing interventions. Methods we conducted a retrospective analysis of the general data, PICC data, and position of catheter tip of 190 obese patients who had PICC for weight reduction surgery in our hospital from May 2018 to June 2019. We used monofactor and multi-factor logistic regression analysis to investigate the risk factors of peripherally inserted central catheter tip misplacement in obese patients who underwent weight reduction surgery. Results We found 29 cases (15.3%) of ectopy of PICC tip among which 13 cases of misplaced tips were found in internal jugular vein, 5 cases in subclavian vein, 4 cases in brachiocephalic veins, 4 cases in right atrium and 3 cases in axillary vein. The monofactor analysis showed that height, weight, BMI of patients, the vein, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the related risk factors of ectopy of PICC tip in obese patients who underwent weight reduction surgery. The multi-factor logistic regression analysis showed that BMI, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the independent risk factors of ectopy of PICC tip. Conclusions Since BMI, arm circumference and the cases of catheters the operators have inserted are the factors that may cause ectopy of PICC tip, we advise the operators should have good experience of inserting catheters and the cases of catheters they have inserted should be≥100; Besides, the location of the vein should be determined by ultrasound B before inserting, the length of catheters should be measured by two nurses, and the ectopy of catheter tip can be prevented and corrected by using ultrasonic probe to press the internal jugular vein.
    VL  - 8
    IS  - 1
    ER  - 

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Author Information
  • Department of Intravenous Catheter Nursing Clinic, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Intravenous Catheter Nursing Clinic, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nursing, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Cardiac Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China

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