title: Repositioning techniques of malpositioned peripherally inserted central catheters.
abstract: OBJECTIVE
  To describe potential repositioning techniques of malpositioned peripherally inserted central catheters.
  
  
  BACKGROUND
  Various repositioning methods have been applied in clinical practice in managing malpositioned peripherally inserted central catheters, and many of them are proved effective. However, little publication reviewed on those literatures describing repositioning techniques to malpositioned peripherally inserted central catheters.
  
  
  METHODS
  Systematic review. The repositioning techniques were classified and concretely described according to different locations of malpositioned peripherally inserted central catheter tips.
  
  
  METHODS
  Literature and relevant guidelines were reviewed, focusing on malpositioned locations and incidence, as well as repositioning skills to peripherally inserted central venous catheters. Six databases were searched, including MEDLINE, web of science, CINAHL, Cochrane library, Wanfang database and Chinese National Knowledge Infrastructure. The articles (n = 21) were analysed using inductive content analysis.
  
  
  RESULTS
  The malpositioned locations of postplacement peripherally inserted central catheter tips mainly include right atrium, right ventricular, axillary vein, ipsilateral and contralateral internal jugular vein, subclavian vein, brachiocephalic vein, other small venous branches or catheter looped. Repositioning techniques contained automatic reposition, manual repositioning techniques, re-advancing catheters and catheters' replacement according to different malpositioned patterns.
  
  
  CONCLUSIONS
  The most appropriate repositioning techniques should be adopted on the basis of malpositioned locations, direction and length of the malpositioned tip, patients' integrated conditions and available medical equipments to maintain the catheter tip in the best position.
  
  
  CONCLUSIONS
  The repositioning techniques described in this review can be applied in clinical practice to ensure the infusion therapy through peripherally inserted central catheter more economical and safe.
authors.affiliation: The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
authors.forename: Jingfen
authors.initials: J
authors.lastname: Jin
authors.forename: Chunfang
authors.initials: C
authors.lastname: Chen
authors.forename: Ruiyi
authors.initials: R
authors.lastname: Zhao
authors.forename: Aiping
authors.initials: A
authors.lastname: Li
authors.forename: Yingqing
authors.initials: Y
authors.lastname: Shentu
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
mesh_terms: D002405:Catheterization, Central Venous / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn