PICC Insertion could be an optimal choice of central venous access in prone position mechanically ventilated COVID-19 ARDS patient

During the management of critically ill covid-19 patients obtaining an appropriate centrally inserted central catheter (CICC) can be a prime necessity. Traditionally, CICC is in supine position. However, may not possible some COVID-19 with severe hypoxia or sudden clinical deterioration who need urgent intubation and immediate proning. Therefore, pronated ARDS challenging. Recent studies limited to case reports have shown that peripherally catheters (PICC) are safer patients. PICC lines minimize mechanical complications lower catheter-related bloodstream infections when compared standard CICC. there scarcity evidence showing efficacy patients, possibly due complex precautionary safety measures, insertion techniques, expertise team deficit. Herein, we present 57-year-old male as ARDS, mechanically ventilated prone position existing subcutaneous emphysema. Our illustrates challenges position, ultrasound guidance comprehend vein’s diameter for accurate vein needling proportion external diameter, intracavitary electrocardiographic (ECG) navigation method confirm tip location. So chest X-ray radiology risk contamination avoided. Long-term research urged validate this group