placed a PICC this morning (4 Fr Groshong). Tip got placed in deep vena cava sup near entry to right atrium. Radiology dept suggested to pull the catheter 1-2 cm, but I told the physician on the ward that it was really fine where it was.
She the told me that they had had a patient with a Hickman residing with the tip some centimeters down into the atrium and he had developed a "thick layer of bacterial growth" on the catheter surface. This growth, the physician told me, was due to the low tip location where the turbulant blood flow would give a higher risk of infection and thrombosis. Thus she wished to pull the PICC 1-2 cm, and I said OK, then you should probably do that.
- Is it correct that a tip location in the atrium means a higher risk of infection and of thrombosis?
- Is tip placement 1-2 cm above cavoatrial junction better than at the junction?