Figure 1 - available via license: Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
Content may be subject to copyright.
Chest X-ray showing the PICC line entangled in the RVAD Figure 2: Lateral chest X-ray showing PICC line in RVAD
Source publication
We report an unknown complication of peripherally inserted central venous catheter in a patient with Ventricular Assist Device. This rare complication led to the failure of the right ventricular assist device, which could be detrimental in patients with dilated cardiomyopathy.
Context in source publication
Context 1
... insertion there was problem with the flows on the right-sided ventricular assist device (VAD) and it was alarming. Lateral and anteroposterior chest X-ray was performed, which showed that the peripheral central venous catheter was stuck in the impella of the Jarvik right ventricular assist device [Figures 1 and 2]. A catheter was stuck as it was inserted too far and due to the suction effect of the device it was sucked in. ...
Citations
... Although rare, caution must be used to avoid the potentially catastrophic entanglement of a PICC line within the RVAD, which can cause malfunction or failure of the ventricular assist device. 2 Employment of shorter midline catheters in the presence of an RVAD may be beneficial where possible in this patient cohort. Alternatively, the use of fluoroscopic guidance at the time of PICC insertion may assist in achieving SVC rather than right atrial tip position at placement. ...
PICC lines are a form of central venous access device.1 At our institution, when PICC lines are inserted without fluoroscopic guidance, a chest X-ray is routinely performed after insertion to confirm the position of the catheter. We present a rare complication of the retraction and extensive twisting of a PICC line likely subsequent to interaction with the patient’s right ventricular assist device (RVAD).
Objective
To explore the preventive effect of applying hot compress with Chinese herbal salt packets (CHSP) to puncture vessels under aseptic conditions during peripherally inserted central catheter (PICC) on postoperative phlebitis. MethodsA total of 720 hospitalized patients undergoing first PICC were assigned to treatment and control groups (360 cases each group) according to a random number table. The control group received conventional catheterization and nursing care. The treatment group was first given hot compress with CHSP (which consisted of honeysuckle 30 g, Semen brassicae 30 g, Salvia miltiorrhiza 30 g, Angelica dahurica 30 g, Semen raphani 30 g, Evodia rutaecarpa 30 g, and coarse salt 20 g) on the punctured vessel under aseptic conditions for 5–10 min before conventional catheterization. The main efficacy indices were the vessel diameters before and during catheterization and the success rate of a single catheter, and the secondary efficacy indiex was the incidence of superficial phlebitis within 1 week after catheterization. ResultsThe vessel diameter during catheterization of the treatment group was remarkably increased compared with the control group [(7.96±0.42) mm vs. (4.39±0.54) mm, P<0.01]. The success rate of the single catheter of the treatment group was significantly higher than that of the control group [94.00% (329/350) vs. 73.72% (244/329), P<0.01]. The incidence of superficial phlebitis within 1 week after catheterization in the treatment group was lower than that in the control group (P=0.007). There was no adverse event with CHSP. Conclusion
Hot compress with CHSP during PICC is applicable as it can effectively improve the success rate of a single catheter and reduce the incidence of superficial phlebitis after catheterization (Trial registration No. ChiCTR-ONC-17010498).
