Uchida Satoshi, Takekawa Daiki, Hori Masaya, Hashiba Eiji, Hirota Kazuyoshi
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
Division of Clinical Engineering, Hirosaki University Hospital, 53 Hon-cho, Hirosaki, 036-8563, Japan.
JA Clin Rep. 2022 Aug 27;8(1):69. doi: 10.1186/s40981-022-00559-8.
Peripherally inserted central catheters (PICCs) are typically placed under fluoroscopy. We used a magnetic tracking and electrocardiogram-based tip confirmation system for insertion of a PICC insertion in a morbidly obese patient at the bedside.
A 53-year-old female with severe obesity (height, 160 cm; weight, 217 kg; BMI, 84.8 kg/m) was admitted to the intensive care unit. Both bilateral, inguinal, and cervical regions were covered with an excess of adipose tissue, making it difficult to place a central venous line. Since transferring her to fluoroscopy seemed dangerous, a PICC was inserted using Sherlock 3CG® TCS at the bedside. Magnetic sensor guidance failed due to the thick subcutaneous tissue her precordium, but intracavity electrocardiography could direct the tip to an appropriate position.
We experienced bedside insertion of a PICC into a patient with BMI of 84.8 kg/m patient using a Sherlock 3CG® TCS. Since the interaction between Sherlock 3CG® TCS and body habitus has not been investigated, further reports are needed.
经外周静脉穿刺中心静脉导管（PICC）通常在荧光透视引导下置入。我们在一名病态肥胖患者的床边使用了基于磁跟踪和心电图的尖端确认系统进行PICC置入。
一名53岁女性，重度肥胖（身高160 cm；体重217 kg；BMI 84.8 kg/m²）入住重症监护病房。双侧腹股沟和颈部均有大量脂肪组织覆盖，难以置入中心静脉导管。由于将她转运至荧光透视室似乎很危险，遂在床边使用Sherlock 3CG® TCS置入PICC。由于其胸前皮下组织过厚，磁传感器引导失败，但腔内心电图可将导管尖端引导至合适位置。
我们使用Sherlock 3CG® TCS在一名BMI为84.8 kg/m²的患者床边成功置入PICC。由于尚未对Sherlock 3CG® TCS与身体体型之间的相互作用进行研究，因此需要更多报告。
