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Pediatric Radiology
Published in: Pediatric Radiology 8/2006

01-08-2006 | Original Article

Influence of arm movement on central tip location of peripherally inserted central catheters (PICCs)

Authors: Bairbre Connolly, Joao Amaral, Sharon Walsh, Michael Temple, Peter Chait, Derek Stephens

Published in: Pediatric Radiology | Issue 8/2006

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Abstract

Background

PICCs are increasingly employed in children. Some of their risks relate to the location of the central tip. Despite care when placing lines, they sometimes move.

Objective

To evaluate the influence of arm movement on the central tip location of PICCs placed in children.

Materials and methods

The central tip location of PICCs was studied in 85 children, with the arm placed in six positions. The variables of side, vein, site and arm position were examined to measure the direction and range of tip movement.

Results

The side, site or vein used did not influence the range of movement of the central tip. Change in position of the arm had a significant influence on the central tip location, moving it an average of 2.2 rib spaces, a maximum of 3.5 ribs. Elbow bending and adduction of the arm caused the central tip to move deeper into the chest, compared to when the arm was straight and abducted 90°.

Conclusion

Arm position is the significant variable influencing PICC movement. Side, site and vein do not influence the range of movement significantly. Most PICCs descend deeper into the chest with arm adduction and elbow bending.
Literature
1.
Chait PG, Ingram J, Phillips-Gordon C, et al (1995) Peripherally inserted central catheters in children. Radiology 197:775–778PubMed
2.
Miller KD, Deitrick CL (1997) Experience with PICC at a university medical center. J Intraven Nurs 20:141–147PubMed
3.
Crowley JJ, Pereira JK, Harris LS, et al (1997) Peripherally inserted central catheters: experience in 523 children. Radiology 204:617–621PubMed
4.
Schutz JC, Patel AA, Clark TW, et al (2004) Relationship between chest port catheter tip position and port malfunction after interventional radiologic placement. J Vasc Interv Radiol 15:581–587PubMed
5.
Connolly B, Mawson JB, MacDonald CE, et al (2000) Fluoroscopic landmark for SVC-RA junction for central venous catheter placement in children. Pediatr Radiol 30:692–695PubMedCrossRef
6.
Racadio JM, Doellman DA, Johnson ND, et al (2001) Pediatric peripherally inserted central catheters: complication rates related to catheter tip location. Pediatrics 107:E28PubMedCrossRef
7.
Hogan MJ (1999) Neonatal vascular catheters and their complications. Radiol Clin North Am 37:1109–1125PubMedCrossRef
8.
Fricke BL, Racadio JM, Duckworth T, et al (2005) Placement of peripherally inserted central catheters without fluoroscopy in children: initial catheter tip position. Radiology 234:887–892PubMedCrossRef
9.
Hacking MB, Brown J, Chisholm DG (2003) Position dependent ventricular tachycardia in two children with peripherally inserted central catheters (PICCs). Paediatr Anaesth 13:527–529PubMedCrossRef
10.
Forauer AR, Alonzo M (2000) Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity. J Vasc Interv Radiol 11:1315–1318PubMedCrossRef
11.
Nadroo AM, Glass RB, Lin J, et al (2002) Changes in upper extremity position cause migration of peripherally inserted central catheters in neonates. Pediatrics 110:131–136PubMedCrossRef
12.
Male C, Julian JA, Massicotte P, et al (2005) Significant association with location of central venous line placement and risk of venous thrombosis in children. Thromb Haemost 94:516–521PubMed
13.
Grove JR, Pevec WC (2000) Venous thrombosis related to peripherally inserted central catheters. J Vasc Interv Radiol 11:837–840PubMedCrossRef
14.
15.
Fletcher SJ, Bodenham AR (2000) Safe placement of central venous catheters: where should the tip of the catheter lie? Br J Anaesth 85:188–191PubMedCrossRef
16.
Department of Health (2001) Review of four neonatal deaths due to cardiac tamponade associated with the presence of a central venous catheter. HMSO, London
Metadata
Title
Influence of arm movement on central tip location of peripherally inserted central catheters (PICCs)
Authors
Bairbre Connolly
Joao Amaral
Sharon Walsh
Michael Temple
Peter Chait
Derek Stephens
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 8/2006
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-006-0172-8

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