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Reducing PICC migrations and improving patient outcomes.

British journal of nursing (Mark Allen Publishing)·2014
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Periphally inserted central catheters- a 'serious' complication.

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Periphally inserted central catheters-a 'serous' complication.

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Summary

Peripherally inserted central catheter (PICC) placement can cause lymph vessel puncture, leading to serous fluid discharge. This article proposes management strategies for this complication, focusing on discharge assessment and catheter removal if symptoms persist.

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Area of Science:

  • Vascular Access
  • Surgical Complications
  • Lymphatic System

Background:

  • Peripherally inserted central catheters (PICCs) are widely used for venous access.
  • Upper arm PICC placement is associated with an increased risk of inadvertent lymph vessel puncture.
  • Puncture leads to lymph fluid leakage and serous discharge at the exit site.

Purpose of the Study:

  • To address the lack of published data on managing lymph vessel puncture complications from PICC lines.
  • To propose evidence-based management strategies for serous fluid discharge secondary to PICC placement.
  • To guide clinicians in assessing and treating this specific PICC-related complication.

Main Methods:

  • Review of existing literature and clinical experience regarding PICC complications.
  • Analysis of the pathophysiology of lymph vessel injury during PICC insertion.
  • Development of a proposed management algorithm based on clinical parameters.

Main Results:

  • Inadvertent lymph vessel puncture during PICC placement is an underreported complication.
  • Serous fluid discharge can range from minimal to excessive.
  • No standardized management guidelines currently exist for this condition.

Conclusions:

  • Lymphatic system injury is a potential complication of upper arm PICC insertion.
  • Management should involve assessing fluid discharge volume and persistence.
  • Catheter removal is recommended for persistent or excessive discharge.