外周静脉穿刺中心静脉置管后胸部X线片质量的改善

Improving Quality of Chest Radiographs After Placement of Peripherally Inserted Central Catheters.

作者信息

Jones Jill, Meek Lucas, Best Shaun, McCann Amy, Welsh Brandon, Hill Jacqueline, Ash Ryan

机构信息

University of Kansas Medical School (Drs Jones, Meek, Best, McCann, and Ash, and Ms Hill), and University of Wisconsin School of Medicine and Public Heath (Dr Welsh). Jill Jones, MD, is an assistant professor of radiology at the University of Kansas Medical Center (KUMC) in Kansas City, Kansas. She completed a medical doctorate, diagnostic radiology residency, and body imaging fellowship at KUMC and a visiting fellowship in body imaging at Mallinckrodt Institute of Radiology in St. Louis, Missouri. Lucas Meek, MD, is an assistant professor of radiology and section head of cardiothoracic radiology at KUMC. He completed a medical doctorate, diagnostic radiology residency, and cardiac imaging fellowship at KUMC, and a visiting fellowship in cardiothoracic imaging at Mayo Clinic in Rochester, Minnesota. Shaun Best, MD, is an assistant professor of radiology and the body imaging fellowship director at KUMC. He completed a medical doctorate and a diagnostic radiology residency at KUMC and a body imaging fellowship at the University of California, San Diego. Amy McCann, MD, completed a medical doctorate and a diagnostic radiology residency at the KUMC, where she is currently a body imaging fellow. Brandon Welsh, MD, completed a medical doctorate at Creighton University School of Medicine and a diagnostic radiology residency at KUMC. He is currently a body imaging fellow at the University of Wisconsin School of Medicine in Madison, Wisconsin. Jacqueline Hill, MPH, is the director of clinical research for the KUMC radiology department and a doctoral candidate in KUMC's health policy and management program. Ryan Ash, MD, is vice chair of radiology at KUMC. He completed a diagnostic radiology residency at KUMC and a body imaging fellowship at the University of California, San Diego. Dr Ash is currently a student in the masters of health care management program at the Harvard TH Chan School for Public Health in Boston, Massachusetts.

出版信息

J Infus Nurs. 2017 Nov/Dec;40(6):359-363. doi: 10.1097/NAN.0000000000000251.

DOI:10.1097/NAN.0000000000000251

PMID:29112583

Abstract

The goal of this study was to determine the best method for localizing peripherally inserted central catheters (PICCs) in postplacement portable chest radiographs. A retrospective analysis showed no significant difference in visualization of the PICC tip between different chest radiograph projections. Modifications were made to an institutional PICC protocol to obtain anteroposterior chest views with the guidewire present only. Repeat analysis demonstrated statistically significant increases in the frequency of anteroposterior radiographs performed, the number of chest radiographs with guidewire, and the localization of the catheter. By standardizing the acquisition of PICC placement chest radiographs, fewer variant projection radiographs were performed and the catheter tip was confidently localized in more examinations.

摘要

本研究的目的是确定在放置外周中心静脉导管（PICC）后便携式胸部X光片中定位导管的最佳方法。一项回顾性分析表明，不同胸部X光片投照方式在PICC尖端显影方面无显著差异。对机构的PICC操作流程进行了修改，以仅在导丝存在的情况下获取前后位胸部影像。重复分析显示，前后位X光片的拍摄频率、带有导丝的胸部X光片数量以及导管定位均有统计学上的显著增加。通过规范PICC放置胸部X光片的采集，进行的变异投照X光片数量减少，并且在更多检查中导管尖端能够可靠定位。