Indications for central venous cannulation in critically ill patients have increased dramatically in recent years owing to the use of more complex therapies unsuitable for delivery via peripheral veins. The main drawbacks of central venous access are morbidity and the growing scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team.
The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on the choice of materials and on vein selection. The advantages and disadvantages of peripherally inserted central venous catheters (PICC) in relation to other types of central venous catheter are discussed, and the principles of use and practical applications of ultrasound for venipuncture are explained. Maneuvers for PICC positioning, techniques for the evaluation of PICC tip placement, and the prevention, diagnosis, and management of complications are all described in detail. Advice is also provided on the organization of a dedicated PICC team within a hospital or a supportive care program, and psychological, legal, and economic issues are considered.