• Mami Tsubota, Marechika Tsubouchi, Yuka Miyazaki, Kenji Iwai, Tetsu Miyoshi, Tsukasa Yajima, Ryohei Matsui, Yota Yamagishi, Asako Matsushima, Tomonori Hattori, and Hiroshi Sasano.
• Department of Advancing Acute Medicine, Nagoya City University Graduate School of Medical Sciences and Medical School, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan. mamitsubota@gmail.com.
• J Anesth. 2024 Dec 6.

PurposeA peripherally inserted central catheter (PICC) placement often requires ultrasound guidance. Previous studies using an adult blood pressure cuff have suggested that veins do not easily collapse at the tourniquet pressure from diastolic to systolic blood pressure. When inserting a PICC into the basilic vein of the upper arm, a narrow blood pressure cuff should be used as a tourniquet to avoid concealing the puncture site. The aim of this study was to determine the appropriate tourniquet pressure using a narrow cuff when inserting a PICC into the upper arm.MethodsWe measured the upper arm's blood pressure of seven healthy participants using a pediatric cuff and applied pressure to the upper arm with the pediatric cuff at six levels: 0 mmHg (0), half of the diastolic pressure (D/2), diastolic pressure (D), pressure obtained by combining the systolic and diastolic pressures and dividing by two (DS), systolic pressure (S), and blood pressure as the pulse wave disappears (S + α). An ultrasound probe compressed the basilic vein through the skin. The pressure at which the vein collapsed at each tourniquet pressure was examined.ResultsThe venous collapse pressure was higher when the tourniquet pressure was D, DS, or S.ConclusionD to S is appropriate for PICC placement in the basilic vein of the upper arm in terms of venous collapse.© 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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