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[When peripheral drips fail: favourable experience with peripherally-inserted central venous catheters].

Maureen E Groote1, Hans van Overhagen, Auke A Nawijn

  • 1HagaZiekenhuis, locatie Leyweg, Den Haag, The Netherlands. megroote@hotmail.com

Nederlands Tijdschrift Voor Geneeskunde
|November 11, 2009
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Summary

Peripherally-inserted central venous catheters (PICCs) offer a safe and effective solution for oncology patients and those with severe infections when peripheral IV access fails. PICCs demonstrate a high success rate with minimal complications, making them a valuable alternative.

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Area of Science:

  • Vascular Access Devices
  • Oncology Patient Care
  • Infectious Disease Management

Background:

  • Difficult peripheral intravenous (IV) access is common in oncology patients and those with severe infections.
  • Central venous access is often required for treatment in these patient populations.
  • Peripherally-inserted central venous catheters (PICCs) offer a less invasive option for central venous access.

Purpose of the Study:

  • To evaluate the technical success rate of PICC insertion.
  • To assess periprocedural complications associated with PICC placement.
  • To determine patient survival and reasons for PICC removal in challenging patient groups.

Main Methods:

  • Retrospective cohort study analyzing patient records and radiological data.
  • Data collected included patient demographics, insertion variables, indwelling time, and reasons for removal.
  • Analysis focused on technical success, complications, and catheter longevity.

Main Results:

  • A high technical success rate of 91% was achieved in 101 PICC insertion attempts across 68 patients.
  • Periprocedural complications were low, occurring in only 2% of cases (hematoma, palpitations).
  • Catheter dwell times varied, with 15% remaining in situ, 50% removed electively, and 35% removed prematurely due to infection, migration, or occlusion.

Conclusions:

  • PICCs are a viable and effective alternative for patients with difficult peripheral IV access, particularly in oncology and infectious disease settings.
  • High technical success and low complication rates support the use of PICCs.
  • The rate of premature removal was deemed acceptable given the mean dwell time, suggesting appropriate utilization.