title: The effect of a mediastinal mass on the initial positioning of a peripherally inserted central venous catheter.
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.
authors.affiliation: Division 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
authors.forename: Robert F
authors.initials: RF
authors.lastname: Tamburro
authors.forename: David T
authors.initials: DT
authors.lastname: Conner
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Proctor
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Butler
authors.forename: Lunetha R
authors.initials: LR
authors.lastname: Britton
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods / Q000451:nursing; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods / Q000451:nursing; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D004868:Equipment Failure; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications* / Q000628:therapy; D015403:Nursing Evaluation Research; D012189:Retrospective Studies; D013714:Tennessee