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• W1985392923 abstract "Editor'Although central catheters inserted peripherally under ultrasound guidance is a common procedure used worldwide,1Pittiruti M La Greca A Scoppettuolo G The electrocardiographic method for positioning the tip of central venous catheters.J Vasc Access. 2011; 12: 280-291Crossref PubMed Scopus (111) Google Scholar 2Konstantinou E Stafylarakis E Kapritsou M et al.Greece reports prototype intervention with first peripherally inserted central catheter: case report and literature review.J Vasc Nurs. 2012; 30: 88-93Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar only recently, navigation systems received a CE mark in Europe. So far the interventional nurses and physicians, in the field of vascular access in Europe, have been using the ECG method, fluoroscopy, and/or anthropometric methods in order to locate the position of the tip in the cavo-atrial junction. This point is considered to have a certain advantage when it comes to intravascular therapy.3Gallieni M Pittiruti M Biffi R Vascular access in oncology patients.CA Cancer J Clin. 2008; 58: 323-346Crossref PubMed Scopus (196) Google Scholar We present, for the first time ever in Europe, two instances where a new navigation system was used for advancing a peripherally inserted central catheter (PICC) (VasoNova, Arrow International, Reading, PA, USA). The device uses real-time internal physiological parameters that are unaffected by the patient's cardio-pathophysiological condition as it is designed to achieve optimal placement of the catheter in the lower third of the superior vena cava and specifically at the cavo-atrial junction. In both cases, the basilic vein was punctured under ultrasound guidance. With further advancement of the catheter for about 20 cm, a red signal came up as the catheter entered the internal jugular vein which was neither compressed nor observed using the ultrasound device for identification. After confirming that the PICC had advanced in the internal jugular, the catheter was pulled back and re-advanced. In total, the PICC was advanced 46 cm from the entrance point (48 cm had been estimated using anthropometric methods). As the PICC reached the optimum point, the maximal P showed up on the navigation device and the bull's eye appeared on the screen (Fig. 1). The procedure in the second patient (an 84-yr-old woman suffering from osteomyelitis who needed to receive i.v. antibiotics and fluid administration for more than 2 months) was performed by a trainee. The whole procedure lasted about 15 min and the advancement of the catheter lasted 3.5 min. At first glance, this navigation system appears to have the feel of a computer game. There is no need for simultaneous ultrasonography of the internal jugular vein. In the unlikely event when the turning of the head towards the ipsilateral side as the lower jaw touches the anterior chest wall will not work effectively, the catheter can be easily pulled back and be re-inserted. We would support the development of this technology in two sectors: to increase the production and potential cost reduction, and the development of sensors that can be re-sterilized. None declared." @default.
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• W1985392923 date "2013-11-01" @default.
• W1985392923 modified "2023-10-18" @default.
• W1985392923 title "Navigation-assisted peripherally inserted central catheter's insertion performed by university degree nurses: technical report of two cases" @default.
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• W1985392923 doi "https://doi.org/10.1093/bja/aet366" @default.
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