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Peripherally inserted central catheters in the intensive care unit.
P K Ng1, M J Ault, L S Maldonado
1Cedars-Sinai Medical Center Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Journal of Intensive Care Medicine
|December 9, 1995
Summary
Peripherally inserted central catheters (PICCs) show a high initial success rate (97.8%) in intensive care unit (ICU) patients. While complications occur, PICCs offer a viable option for venous access in critically ill individuals.
Area of Science:
- Medical Devices
- Critical Care Medicine
- Vascular Access
Background:
- Peripherally inserted central catheters (PICCs) are increasingly utilized for venous access.
- Assessing their efficacy and safety in intensive care unit (ICU) settings is crucial.
Purpose of the Study:
- To evaluate the success rate and complication profile of PICCs in hospitalized ICU patients.
- To determine the overall success rate for completing therapy using PICCs.
Main Methods:
- A cohort study was conducted in a large tertiary care, university-affiliated community hospital's ICU.
- Included were all ICU patients for whom a PICC consultation was requested.
- Outcomes measured included initial placement success, placement complications, and overall therapy completion success and complications.
Main Results:
- 97.8% of 91 attempted PICC placements were successful, with 28% requiring cutdown.
- 20 initial placement complications and 8 delayed complications were observed in 19 PICCs.
- The overall success rate for completing therapy was 74.7%, with catheter dislodgement and potential infection being primary reasons for failure. Confirmed infection rate was low (6/10,000 patient days).
Conclusions:
- PICCs demonstrate a high initial success rate and a reasonable overall success rate for therapy completion in critically ill patients.
- PICCs represent a viable alternative for central venous access in the ICU.
- Further evaluation of PICC use in critically ill populations is warranted.