Authors
Jung Rae Cho, Hancheol Jo, Dae Sung Ma, Dong Hun Kim
Published in
Acute and critical care. Volume 41. Issue 3. Pages 631-640. Epub Aug 31, 2026.
Abstract
Transporting critically ill trauma patients for fluoroscopy-guided peripherally inserted central catheter (PICC) placement poses substantial risks. This study evaluated the clinical outcomes of bedside PICC insertion using a surface anatomical landmark-based measurement in a trauma intensive care unit (ICU).
This retrospective cohort study included trauma ICU patients who underwent PICC insertion between September 2023 and August 2024 at a regional trauma center. Insertion location was categorized as bedside or fluoroscopy-guided. Outcomes included optimal tip positioning, aberrant-course malposition, complication rates, and catheter dwell time. Multivariable linear regression identified factors associated with PICC duration.
Among 282 PICC procedures (171 bedside, 111 fluoroscopy), the bedside group had significantly higher injury severity scores and more frequent mechanical ventilation. Using the cmbased carina-distance criterion, optimal tip positioning was achieved in 73.1% of bedside and 65.5% of evaluable fluoroscopy-guided insertions (P=0.184). However, using the vertebral body unit-based radiologic criterion, target-zone achievement was lower in the bedside group than in the fluoroscopy group (48.5% vs. 64.9%). Initial aberrant-course malposition occurred in nine bedside insertions (5.3%) and in no fluoroscopy-guided insertions, and all were corrected before clinical use. Overall complication rates were comparable (17.5% vs. 18.0%, P=0.919).
Bedside PICC insertion using a surface anatomical measurement method may be a feasible transport-free option for selected critically ill trauma ICU patients.
PMID:
42723455
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.
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