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Validation of the PICC length prediction formula based on anteroposterior chest radiographs for bedside ultrasound-guided placementopen access

Authors
Cho, YoungjongLee, SangjoonPark, Sung-JoonLee, Hyoung NamChung, Hwan Hoon
Issue Date
Nov-2022
Publisher
Public Library of Science
Citation
PLoS ONE, v.17, no.11
Indexed
SCIE
SCOPUS
Journal Title
PLoS ONE
Volume
17
Number
11
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62481
DOI
10.1371/journal.pone.0277526
ISSN
1932-6203
Abstract
This study aimed to validate the accuracy of the peripherally inserted central catheter (PICC) length prediction formula using only anteroposterior chest radiographs (AP-CXR) and the technical feasibility of bedside ultrasound-guided PICC placement. This study included 156 Asian adult patients who underwent bedside PICC placement at three hospitals from September 2021 to March 2022. The shortest straight-line distance from the cubital crease to the puncture point (CP) was measured first. Using the formula of a previous study, the CP + estimated PICC length (eCL) was calculated with the parameters measured on AP-CXR. The formula was as follows: 19.409 + 0.424 x (MHTD, maximal horizontal thoracic diameter) + 0.287 x (CL, clavicle length) + 0.203 x (DTV, distance of thoracic vertebrae) + (2VBUs, two vertebral body units below the carina inferior border) (if from the left, 3.063cm was added; if female, 0.997cm was subtracted). Catheters were pretrimmed according to calculated eCL prior to the procedure. Technical success was evaluated, and the validation success of catheter length prediction was classified according to the catheter tip position as follows: optimal position or suboptimal position. Technical success was achieved in 153 cases (98.1%). Evaluation of validation success revealed that the position was "optimal" in 108 cases (70.6%) and "suboptimal" in 45 cases (29.4%). There was no validation failure. There was no case where the catheter was inserted too deep as to wedge into the right atrial wall. In conclusion, the PICC could be positioned accurately using the formula based on only AP-CXR. Furthermore, this bedside procedure was technically feasible.
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Chung, Hwan Hoon
Ansan Hospital (Department of Radiology, Ansan Hospital)
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