title: A randomised, controlled trial comparing the long-term effects of peripherally inserted central catheter placement in chemotherapy patients using B-mode ultrasound with modified Seldinger technique versus blind puncture.
abstract: OBJECTIVE
  To compare the effects of peripherally inserted central venous catheter (PICC) placement using B-mode ultrasound with the modified Seldinger technique (BUMST) versus the blind puncture.
  
  
  METHODS
  One hundred chemotherapy patients were recruited to participate in a randomised, controlled trial in Guangzhou, China. Fifty were assigned to the experimental group (using BUMST), and 50 were assigned to the control group (blind puncture). Demographic and background data, data related to PICC placement, complications after PICC placement, the patients' degree of comfort (determined via a questionnaire), and patients' costs for PICC maintenance were collected to compare the effects of the two methods. T-tests and chi-square tests were used to analyse the data; p < 0.05 was accepted as statistically significant.
  
  
  RESULTS
  Nighty-eight of the 100 PICCs were successfully inserted (50 in the experimental group and 48 in the control group). Compared with the control group, the experimental group had a lower rate of unplanned catheter removal (4.0% vs. 18.7%; p = 0.02), a lower incidence of mechanical phlebitis (0% vs. 22.9%; p < 0.001), a lower incidence of venous thrombosis (0% vs. 8.3%; p = 0.037), and a higher incidence of catheter migration (32% vs. 2.1%; p < 0.001). Compared with the control group, the experimental group experienced significantly less severe contact dermatitis (p = 0.038), had improved comfort at 1 week, 1 month, 2 months, and 3 months after PICC placement (p < 0.001), and had lower costs for PICC maintenance at 2 months, 3 months and when the catheter was removed (p < 0.05).
  
  
  CONCLUSIONS
  Using B-mode ultrasound with MST for PICC placement reduced complications and patients' costs for PICC maintenance and improved patients' degree of comfort; thus, this procedure should be more widely used. The clinical trial registration number: ChiCTR-TRC-12002749.
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Yu-Ying
authors.initials: YY
authors.lastname: Fan
authors.affiliation: Department of Nursing, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Ming-Zhu
authors.initials: MZ
authors.lastname: Xin
authors.affiliation: Department of Nursing, Sun Yat-sen University, No. 74 2nd Zhongshan Road, Yuexiu District, Guangzhou, Guangdong 510080, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Catheter Outpatients, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Huang
authors.affiliation: Department of Catheter Outpatients, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China.
authors.forename: Xi-Ling
authors.initials: XL
authors.lastname: Lin
authors.affiliation: Department of Nursing, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, China. Electronic address: qinhy@sysucc.org.cn.
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Qin
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D055499:Catheter-Related Infections / Q000000981:diagnostic imaging / Q000453:epidemiology; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods*; D062905:Central Venous Catheters / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002681:China; D003877:Dermatitis, Contact / Q000209:etiology / Q000503:physiopathology; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D011677:Punctures; D012016:Reference Values; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D020246:Venous Thrombosis / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult
keywords: B-mode ultrasound with MST; Central line; Chemotherapy; Nursing; PICC placement