Repositioning techniques of malpositioned peripherally inserted central catheters
Article first published online: 14 DEC 2012
© 2012 Blackwell Publishing Ltd
Journal of Clinical Nursing
Volume 22, Issue 13-14, pages 1791–1804, July 2013
How to Cite
Jin, J., Chen, C., Zhao, R., Li, A., Shentu, Y. and Jiang, N. (2013), Repositioning techniques of malpositioned peripherally inserted central catheters. Journal of Clinical Nursing, 22: 1791–1804. doi: 10.1111/jocn.12004
- Issue published online: 8 JUN 2013
- Article first published online: 14 DEC 2012
- Manuscript Accepted: 29 JUL 2012
- PICC ;
- repositioning technique
Aims and objectives
To describe potential repositioning techniques of malpositioned peripherally inserted central catheters.
Various repositioning methods have been applied in clinical practice in managing malpositioned peripherally inserted central catheters, and many of them are proved effective. However, little publication reviewed on those literatures describing repositioning techniques to malpositioned peripherally inserted central catheters.
Systematic review. The repositioning techniques were classified and concretely described according to different locations of malpositioned peripherally inserted central catheter tips.
Literature and relevant guidelines were reviewed, focusing on malpositioned locations and incidence, as well as repositioning skills to peripherally inserted central venous catheters. Six databases were searched, including MEDLINE, web of science, CINAHL, Cochrane library, Wanfang database and Chinese National Knowledge Infrastructure. The articles (n = 21) were analysed using inductive content analysis.
The malpositioned locations of postplacement peripherally inserted central catheter tips mainly include right atrium, right ventricular, axillary vein, ipsilateral and contralateral internal jugular vein, subclavian vein, brachiocephalic vein, other small venous branches or catheter looped. Repositioning techniques contained automatic reposition, manual repositioning techniques, re-advancing catheters and catheters' replacement according to different malpositioned patterns.
The most appropriate repositioning techniques should be adopted on the basis of malpositioned locations, direction and length of the malpositioned tip, patients' integrated conditions and available medical equipments to maintain the catheter tip in the best position.
Relevance to clinical practice
The repositioning techniques described in this review can be applied in clinical practice to ensure the infusion therapy through peripherally inserted central catheter more economical and safe.