Comparison and analysis of tip malposition after different central venous catheterizations

ABSTRACT:Objective To compare and analyze tip malposition of 2 central venous catheteri-zations in cancer patients.Methods Totally 1656 cancer patients received 1799 cases of peripheral-ly inserted central catheter(PICC)/conventional central venous catheter(CVC)were consecutively assessed by means of routine post-catheterization chest X-ray.The catheter with its tip strike and terminal position were confirmed individually.All tip malpositions were calculated.And the catheters with tip malpositions were readjusted and reevaluated.Results The failure rate in PICC group (2.68%)was significantly higher than that in CVC group(0.34%,P <0.01).Eighty three catheters(4.84%)were found tip malpositioned,in which 38 catheters(6.42%)were from PICC group and 45 ones(4.01%)from CVC group (P <0.01).The achievement ratio of readjustment for tip malposition in PICC group (71.1%)was much higher than that in CVC group (26.7%,P<0.01).Conclusion Compared with CVCs in cancer patients,the prevalence of tip malposition from PICCs was higher although the tip malpositions in PICCs were more likely to be corrected with readjustment.These findings suggest that tip position of PICC /CVC should be confirmed post-catheterization with chest x-ray.