Complicaciones derivadas de la inserción periférica de catéter central con punción ciega o ecoguiada.

Abstract

Objective: to determine the impact of the ultrasound-guided technique for peripherally-inserted central catheters (PICCs) vs. blind puncture, on the incidence of phlebitis and other complications in oncology patients. Method: an observational, analytical, retrospective cohort study (blind puncture arm vs. arm with ultrasound-guided technique). The study included 168 patients with a PICC inserted from 2013 to 2015 (selected through simple random sampling), with blind (n= 114) or ultrasound-guided puncture (n= 54) at the Day Hospital of the ICO-Hospital Duran i Reynals (Barcelona). The variables studied were: incidence of phlebitis and other catheter-related complications, time until the development of complications, reason for removal, and time of catheter duration. Results: the mean age of patients in both arms was similar (59.3 years in the blind puncture arm and 59.7 years in the arm with ultrasound-guided technique). The most frequent tumour was head and neck, though with significant differences in distribution between both arms. Phlebitis was the complication with the highest incidence, which occurred in 16.7% of the blind puncture arm vs. 1.8% with ultrasound-guided insertion (RR= 0.11; p= 0.012). The mean time for phlebitis development was 30 days (SD: 6.93) for ultrasound-guided catheters, and 11 days (SD: 8.58) for those inserted without ultrasound (p= 0.002). Conclusions: the implementation of the ultrasound-guided technique for PICC insertion vs. blind puncture was associated with a reduction in the incidence of phlebitis and the time to its development. KEYWORDS: Peripherally-inserted Central Catheter (PICC); ultrasound; Phlebitis; Oncology Nursing: cohort study