Journal of Clinical and Experimental Investigations

Abstract

Objectives: Peripherally inserted central venous catheters (PICCs) are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia
Methods: ‘Central Venous Catheterization Forms’ filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009 and March 2013 in the operating room of Uludag University Medical Faculty Hospital were retrospectively analysed.
Results: A total of 1174 procedures were evaluated. The most preferred vein for the first attempt was the right basilic vein (32.7%). Difficulty (more than two attempts) with the PICC procedure was correlated with the patient’s age (p<0.001), BMI <20 kg/m² (p<0.05), previously used vein (p<0.001) and resident’s experience (p<0.001). A total of 8.2% of patients had complications, with the most frequent complication subcutaneous haematoma at the procedure site (5.3%). Risk factors for complications were advanced age (p<0.05), female gender (p=0.024), BMI >30 kg/m² (p<0.05), resident with less than 4 years of training (p=0.001), number of PICC attempts ≥2 (p<0.001), more than one resident involved in the catheterization procedure (p<0.001) and previous failed PICC procedures (p<0.001).
Conclusion: We conclude that catheterization should be performed under the surveillance of a staff keeping in mind the risks of complications. In the case of failure following 2 attempts, the procedure should be handed over to a more experienced staff member.