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Published on: December 23, 2014
Cutting peripherally inserted central catheters may lead to increased rates of catheter-related deep vein thrombosis
Denise Steele1, Colleen M Norris
1Misericordia Community Hospital, Covenant Health, Edmonton, Alberta, Canada (Ms Steele); and Faculty of Nursing, University of Alberta and Heart Health and Stroke Strategic Clinical Networks, Alberta Health Services, Edmonton, Alberta, Canada (Dr Norris). Denise Steele, BSN, VA-BC, is a parenteral nurse clinician at Misericordia Hospital, where she leads the parenteral therapy team and develops infusion therapy policies and procedures for Covenant Health. Colleen M. Norris, PhD, is a professor in the faculty of nursing, an associate director of the research division of cardiovascular surgery, and an adjunct professor in the faculty of medicine in the School of Public Health Sciences at the University of Alberta. She is also the scientific director of the Heart Health and Stroke Strategic Clinical Network for Alberta Health Services.
Abstract:
The purpose of this study was to determine whether an association exists between cutting or trimming peripherally inserted central catheters (PICCs) and the development of deep vein thromboses (DVTs). An observational, retrospective study was conducted on 634 patients who had a PICC inserted between 2011 and 2012. Patients who had a reverse-taper PICC inserted were assigned into 1 of 2 groups. The first group included patients with a reverse-taper PICC that was cut/trimmed (PC) before insertion (n = 224). The second group was made up of patients whose PICC was not cut/trimmed (PNC) before insertion (n = 410). All PICC-associated DVTs were confirmed by a positive venous Doppler result and recorded. A statistically significant difference (P < .001) was found between patients in the PC group who developed a DVT (9.82%) and patients in the PNC group in which PICCs were not trimmed (1.95%). There is evidence to suggest that altering the reverse-taper PICC by cutting or trimming the tip before insertion may be associated with increased DVTs. Further study is required to determine whether PICCs should be reduced in length or whether there is an appropriate method of trimming the catheter to ensure its stability after insertion.
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