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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

Published on: July 13, 2019

Peripherally inserted central catheters with distal versus proximal valves: prospective randomized trial

E K Hoffer1, R D Bloch, J J Borsa

  • 1Department of Radiology, Section of Vascular and Interventional Radiology, Box 359728, Harborview Medical Center, 325 9th Avenue, Seattle, Washington 98104, USA. rhoffer@u.washington.edu

Journal of Vascular and Interventional Radiology : JVIR
|October 5, 2001
PubMed

Insights

Peripherally inserted central catheters (PICCs) with proximal valves showed better durability and a trend toward fewer complications than those with distal valves. This suggests proximal valves may offer an advantage for long-term use.

Area of Science:

  • Vascular Access Devices
  • Medical Device Engineering
  • Infectious Disease Prevention

Background:

  • Peripherally inserted central catheters (PICCs) are crucial for long-term intravenous therapy.
  • Catheter design, particularly valve placement, may influence complication rates and device durability.
  • Understanding the comparative performance of different valved PICC designs is essential for optimizing patient care.

Purpose of the Study:

  • To compare the efficacy of peripherally inserted central catheters (PICCs) with proximal valves versus distal valves.
  • To evaluate differences in occlusion, infection, and malfunction rates between proximal and distal valved PICCs.
  • To assess the durability and fracture incidence of proximal versus distal valved PICCs.

Main Methods:

  • A randomized trial involving 100 patients comparing proximal-valved (n=52) and distal-valved (n=48) single-lumen 4-F PICCs.
  • Catheter placement guided by fluoroscopy or sonography, primarily for antibiotic administration.
  • Standardized procedures for placement, maintenance, and follow-up for both catheter types.

Main Results:

  • All 100 patients achieved successful percutaneous placement with the catheter tip in central veins.
  • The proximal valve group experienced fewer occlusive/infectious complications (11.5%) compared to the distal valve group (25%), though not statistically significant (P = .08).
  • A significant difference in catheter fractures was observed, with 5.8% in the proximal valve group versus 35.4% in the distal valve group (P < .01).

Conclusions:

  • Proximal-valved PICCs demonstrated significantly superior durability compared to distal-valved PICCs.
  • A trend suggests proximal-valved PICCs may be associated with fewer occlusive and infectious complications.
  • The findings indicate a preference for proximal-valved PICCs due to improved device longevity and potentially reduced complication rates.
Abstract

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