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The effect of a mediastinal mass on the initial positioning of a peripherally inserted central venous catheter
Robert F Tamburro1, David T Conner, Kimberly E Proctor
1Division of Critical Care Medicine, St. Jude Children's Research Hospital and Department of Medicine, Le Bonheur Children's Medical Center, University of Tennessee, Memphis 38105-2794, USA. robert.tamburro@stjude.org
Abstract:
The purpose of this project was to assess if the presence of a mediastinal mass adversely influences peripherally inserted central catheter (PICC) positioning. A retrospective review of all PICC placements over an 18-month period in a pediatric oncology hospital was conducted in which patients were categorized by the presence or absence of a mediastinal mass. A much higher proportion of patients with a mediastinal mass (8 of 13) had a malpositioned catheter than those without a mass (3 of 38; P = .0002). A significant proportion of the malpositioned catheters in patients with a mediastinal mass terminated in the right heart chambers. These findings show that clinicians must be vigilant about checking for PICC malpositioning in this patient population.