Edanaga Mitsutaka, Sato Honami, Ochiai Gen, Yamakage Michiaki
Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, JPN.
Anesthesiology, Kushiro City General Hospital, Kushiro, JPN.
Cureus. 2023 Jun 20;15(6):e40711. doi: 10.7759/cureus.40711. eCollection 2023 Jun.
A first analysis of deaths due to central venous catheterization (CVC) in Japan in 2017 reported peripherally inserted central catheterization (PICC) as an alternative to CVC. In 2018, Sherlock™ 3CG (C.R. Bard Inc., New Jersey, USA) and Power PICC became available for use in Japan. The electromagnetic mechanism of the Sherlock 3CG system often eliminates the need for the use of fluoroscopic devices, such as C-arm scanners. In this clinical report, we describe five cases of patients who underwent PICC guided by the Sherlock 3CG system and were evaluated by transesophageal echocardiography (TEE). The patients were adapted for PICC for highly invasive urologic, thoracic, and dental surgery. Also, the positions of the catheter tip were confirmed by TEE in all cases. The mean distance from the access vein to the catheter tip was 41.1 ± 3.8 cm. Chest X-ray analysis showed a mean distance of 40.0 ± 21.5 mm between the carina and catheter tip. Bicaval TEE views showed that the Power PICC tip had not been advanced into the right atrium in any of the cases. We concluded that the tip positions of the Power PICC guided by the Sherlock 3CG system were almost deeper than Zone B and not in the right atrium.
对2017年日本中心静脉置管（CVC）导致的死亡情况进行的首次分析报告称，经外周静脉穿刺中心静脉置管（PICC）可作为CVC的替代方法。2018年，Sherlock™ 3CG（美国新泽西州C.R. Bard公司）和Power PICC在日本开始可供使用。Sherlock 3CG系统的电磁机制常常无需使用荧光透视设备，如C型臂扫描仪。在本临床报告中，我们描述了5例在Sherlock 3CG系统引导下接受PICC并经食管超声心动图（TEE）评估的患者。这些患者因高侵入性泌尿外科、胸科和牙科手术而适合进行PICC。此外，所有病例均通过TEE确认了导管尖端的位置。从穿刺静脉到导管尖端的平均距离为41.1±3.8厘米。胸部X线分析显示，气管隆突与导管尖端之间的平均距离为40.0±21.5毫米。双腔TEE视图显示，所有病例中Power PICC尖端均未进入右心房。我们得出结论，Sherlock 3CG系统引导下的Power PICC尖端位置几乎均深于B区，且不在右心房内。
