An integrated system for Peripherally Inserted Central Catheter tip confirmation in oncology and haematology patients

Introduction: Although there are many methods to confirm vascular device tip, chest x-ray represents the recommended procedure to verify the correct positioning of a central device, but it exposes patients to x-rays, delays treatment, and permits device length to be checked post-procedure. Aim: To evaluate the efficacy of Peripherally Inserted Central Catheter positioning through an Integrated System (ultrasound-guided and electrocardiogram confirmation). Methods: A case-control study was conducted on a randomized sample of 165 patients, requiring Peripherally Inserted Central Catheter placement for chemotherapy treatment. The case group was composed of patients with vascular device placed through the Integrated System and the control group devices' length was anthropometrically estimated. Chest radiography was performed on both groups to verify tip location. Results: No cases of primary malposition related to the Integrated System were registered. The vascular devices positioned with the Integrated System were all correctly placed and in 91.8% (n=101) the intra-procedural tip location was comparable to the one identified in the x-ray. Conclusion: The Integrated System represented a simple and efficient method to correctly place vascular device, allowing intra-procedural tip confirmation and avoiding primary malposition. It would eliminate the need for performing chest radiography, reduce costs and time for healthcare professionals and patients.