The peripherally inserted central catheter: what are the current indications for its use?

Area of Science:

• Medical Devices
• Vascular Access
• Infection Control

Background:

• Peripherally inserted central catheters (PICCs) have seen a significant rise in utilization for IV therapy since the 1980s.
• PICC sales rank second only to acute care central venous catheters, surpassing other long-term venous access devices.
• PICC usage has notably expanded within the home care sector.

Purpose of the Study:

• To evaluate the complication rates and device survivability of PICCs.
• To compare PICC complications with other central venous access devices.
• To determine the optimal use cases for PICCs based on dwell time and care setting.

Main Methods:

• Review of existing studies examining PICC complications.
• Comparative analysis of PICC complication incidence against other central venous access devices.
• Assessment of complication-free days and device survivability based on dwell times.

Main Results:

• PICC complications are comparable to other devices in short-term use.
• Extended dwell times (beyond a few weeks) correlate with reduced complication-free days.
• Longer dwell times are associated with decreased device survivability rates for PICCs.

Conclusions:

• PICCs are most suitable for acute care or short-term home care applications.
• PICCs may not be the ideal choice when long-term central venous access is anticipated.
• Careful consideration of dwell time is crucial for optimizing PICC use and patient outcomes.