A Randomized Controlled Trial To Compare Double Arm On The Clinical Effects Of Peripherally Inserted Central Venous Catheter

Objective:To campare the other analysis of the rate of first attempt on catheterization,and the complication rate during the procedural and after placement,and provided evidence for the side choice of PICC.Methods:This is a prospective,randomized,parallel and controlled trial.516 patients who needed PICC placement at Sir Run Run Show Hospital were randomized into two groups:one received catheterization on the left arm and the other on the right arm.The success rate of first attempt on catheterization,the requirements of adjustment during the procedural,and the complication rate after placement(e.g.,malposition,catheter slippage,thrombosis,phlebitis,secondary malposition,catheter blockage,infection,leaking,and bleeding)were compared between the two groups.Results:Among 516 cases,44 cases were lost,and 472 patients completed the data collection,with 232 cases from the left upper limb group and 240 from the right upper limb group.No significant differences were detected between the two group in terms of the success rate of first attempton catheterization,the incidences of primary malposition, catheter slippage,catheter blockage,phlebitis,infection,thrombosis,leakage,or bleeding(P>0.05).However,there were significant differences between the two groups in terms of the adjustment during the procedural,catheter tip malposition in the internal jugular vein,and secondary malposition(P<0.05).Conclusion:1.There were no significant differences between the left and right upper limbs in terms of the rate of adjustment during the procedural;Catheterization on the right side required less adjustments during the placement than the left side;The incidence rate of ectopic internal jugular vein of right upper limb is higher than the rate of left upper limb.2.Catheterization on the left side had lower incidence of secondary malposition than the right side.3.No significant differences were detected between the two group in terms of the success rate of first attempton catheterization,the incidences of primary malposition,catheter slippage,catheter blockage,phlebitis,infection,thrombosis,leakage,or bleeding4.We propose that in clinical practice of PICC catheterization,after full assessment of the patients' venous condition,the large,straight,good elasticted vein should be chosen and trying to meet the demands of individuation at the same time.5.To the cases who have high incidence rate of secondary malposition(e.g.,obvious cough,high pressure of thoracic cavity),Left arm should be considered as the preferred side except for some special cases that have contraindication of PICC catheterization in the left arm,during PICC placement.