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Peripherally inserted central catheters (PICCs) in the CF population: one center's experience
Concettina Tolomeo1, Wendy Mackey
1Section of Pediatric Respiratory Medicine, Yale School of Medicine, New Haven, CT, USA.
Insights
Peripherally inserted central catheters (PICCs) provide effective intravenous antibiotic delivery for cystic fibrosis (CF) patients. While minor complications occurred, PICCs ensured high completion rates for CF pulmonary exacerbation treatments.
Area of Science:
- Medical Science
- Pulmonology
- Infectious Diseases
Background:
- Cystic fibrosis (CF) is a genetic disorder causing chronic pulmonary infections requiring intravenous (i.v.) antibiotics.
- Peripherally inserted central catheters (PICCs) are an established method for i.v. drug delivery across various patient groups.
Purpose of the Study:
- To evaluate the effectiveness and safety of using PICCs for i.v. antibiotic administration in patients with CF.
- To assess complication rates and treatment completion associated with PICC use in this population.
Main Methods:
- A retrospective analysis of 61 PICCs placed in 32 CF patients over 25 months.
- Data collected included duration of catheter use, complications, and i.v. antibiotic completion rates.
Main Results:
- PICCs were in place for a median of 15 days (range 1-155), totaling 1,139 catheter days.
- Minor complications (18/61 catheters, 29.5%) included external breaks, pain, phlebitis, occlusion, dislodgement, local irritation, and infection.
- No serious complications or long-term sequelae were reported; i.v. antibiotic completion rates were high.
Conclusions:
- PICC placement is a safe and effective method for delivering i.v. antibiotics in CF patients with pulmonary exacerbations.
- PICC access is maintained as the standard of care for i.v. antibiotic therapy at the CF center.
Abstract:
Cystic fibrosis (CF) is a common fatal genetic disorder characterized by chronic pulmonary infections, some of which require intravenous (i.v.) antibiotics. Peripherally inserted central catheters (PICCs) have proven to be an effective means of i.v. delivery in a variety of populations. An evaluation of the effectiveness of the use of PICCs for patients at a CF center in New England was conducted over a 25-consecutive month period. During this time, 61 PICCs were placed in 32 patients with CF requiring i.v. antibiotics. The catheters were in place for a median of 15 days (range 1-155 days). The total number of catheter days in this series was 1,139. Although no serious complications were encountered, minor complications or technical problems occurred in 18 (29.5%) of the 61 catheters. Complications included external breaks in the catheters, shoulder pain, phlebitis, catheter occlusion, accidental dislodgement, local irritation at the insertion site, and yeast infection at the insertion site. No long-term sequelae resulted, and the rate of i.v. antibiotic completion with this mode of i.v. access was high. As a result of the evaluation, PICC access remains the standard of care at this institution for patients with CF requiring i.v. antibiotics for pulmonary exacerbations.
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