Risk Factors of Ectopy of Peripherally Inserted Central Catheter in Obese Patients After Weight Reduction Surgery and Related Nursing Interventions

Abstract

Objective We analyze risk factors of ectopy of peripherally inserted central catheter tip in obese patients after weight reduction surgery and explore effective nursing interventions. Methods we conducted a retrospective analysis of the general data, PICC data, and position of catheter tip of 190 obese patients who had PICC for weight reduction surgery in our hospital from May 2018 to June 2019. We used monofactor and multi-factor logistic regression analysis to investigate the risk factors of peripherally inserted central catheter tip misplacement in obese patients who underwent weight reduction surgery. Results We found 29 cases (15.3%) of ectopy of PICC tip among which 13 cases of misplaced tips were found in internal jugular vein, 5 cases in subclavian vein, 4 cases in brachiocephalic veins, 4 cases in right atrium and 3 cases in axillary vein. The monofactor analysis showed that height, weight, BMI of patients, the vein, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the related risk factors of ectopy of PICC tip in obese patients who underwent weight reduction surgery. The multi-factor logistic regression analysis showed that BMI, arm circumference and experience of operators (how many cases of catheters the operators have inserted) (P<0.05) were the independent risk factors of ectopy of PICC tip. Conclusions Since BMI, arm circumference and the cases of catheters the operators have inserted are the factors that may cause ectopy of PICC tip, we advise the operators should have good experience of inserting catheters and the cases of catheters they have inserted should be≥100; Besides, the location of the vein should be determined by ultrasound B before inserting, the length of catheters should be measured by two nurses, and the ectopy of catheter tip can be prevented and corrected by using ultrasonic probe to press the internal jugular vein.