Ensuring the stability of central venous catheter placement for treating patients hospitalized in an intensive care unit is very important. Although PICC requires an ultrasound and fluoroscopy machine, it is difficult to use a fluoroscopy machine for PICC insertion in the intensive care unit. This study analyzed the cases of the insertion of a PICC under ultrasonic guidance at the bedsides in the intensive care unit to determine the usefulness of PICC in the intensive care unit.

A retrospective study was conducted on patients hospitalized in the surgical intensive care unit and received PICC using ultrasonography at their bedsides from October 2015 to January 2018.

One hundred and twenty patients were collected. The number of successful PICCs stood at 105 patients, which was equal to 87.5%. Among them, 65 and 55 cases had left and right insertion, respectively; the corresponding success rate was 81.8%, and 92.3%. No statistically significant difference in success rates was observed between the left and right, as well as in the success rates depending on the presence of shock, sepsis, acute kidney injury, and mechanical ventilation. In the failed 15 cases, seven cases were due to the course of the procedure and eight cases were confirmed have been malpositioned after insertion.

PICC at the bedside in an intensive care unit is a safe method for central venous catheterization without severe complications and death. The insertion sites, left or right, are equally acceptable. Further study of the cases of malposition will be necessary.

Patients in the intensive care unit (ICU) are more susceptible to nosocomial infections, including central line-associated bloodstream infection (CLABSI), surgical site infection, urinary tract infection or ventilator-associated pneumonia. This study is a comparative analysis of how central venous catheter (CVC) management staff affects CLABSI.

We performed a two-phase review of all patients transferred to the surgical ICU (SICU) from January 2013 to June 2014. CVC management staff was introduced in October 2013. Electronic medical records provided the data for a comparative analysis of incidence rates and risks of CLABSI, as well as the subjects’ general characteristics.

This study included 248 patients before the introduction of a CVC management staff member and 196 patients after the introduction. General patient characteristics before and after the CVC management staff was in place did not differ significantly. The CLABSI rate decreased by 4.61 cases/1,000 device days after the introduction (6.26 vs. 1.65; odds ratio, 4.47; 95% confidence interval, 1.39∼14.37; p=0.009). However, the mortality rate and length of ICU stay did not change after CVC management staff was in place (12.9% vs. 10.7%, p=0.480; 16.00±24.89 vs. 15.87±18.80, p=0.954; respectively).

In this study, the introduction of CVC management staff effectively reduced CLABSI rates in current ICU system.

A peripherally inserted central catheter (PICC) provides effective, reliable intravenous access in patients who require long term therapy such as intravenous antibiotics, total parenteral nutrition, transfusion or inotropic agents. This retrospective study evaluated the usefulness of PICC in trauma patients by examining patient characteristics and common complications, including PICC related bloodstream infection.

We reviewed the trauma patients who underwent PICC at Pusan National University Hospital Trauma Center from January 2016 to February 2017.

From January 2016 to February 2017, 32 patients underwent PICC. Total catheter insertion days were 875 days, and the average catheter indwelling time was 27.3±25.02 days. The most common indication for PICC was total parenteral nutrition (n=20, 62.5%), while the remainder was to ensure a long-term fluid administration route (n=12, 37.5%). Catheter related complications included infection (n=3, 9.4%; 3.42 per 1,000 catheter-days), catheter tip malposition (n=2, 6.3%), catheter dislodgement (n=1, 3.1%), insertion site leakage (n=1, 3.1%) and arm swelling (n=1, 3.1%). No statistically significant differences were found between those who developed bloodstream infection and those who did not.

If the PICC is performed by correcting adjustable factors that increase the risk of infection, effective and reliable intravenous access can be maintained in patients who require long-term therapy without bleeding, pneumothorax, or other complications of central venous catheter insertion.