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Published on: July 13, 2019
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Peripherally inserted central catheter design and material for reducing catheter failure and complications
Jessica A Schults1,2, Tricia Kleidon3, Karina Charles2
1Herston Infectious Disease Institute, Metro North Health, Brisbane, Australia.
The Cochrane Database of Systematic Reviews
|June 28, 2024
Summary
This study found limited evidence that PICC materials and design significantly impact complications like VTE or BSI. More high-quality trials are needed to determine the effectiveness of different peripherally inserted central catheter designs.
Area of Science:
- Medical Devices
- Vascular Access
- Infectious Disease Prevention
Background:
- Peripherally inserted central catheters (PICCs) are crucial for patient care but prone to complications.
- PICC material and design may influence the incidence of infective and non-infective complications.
- Catheter failure leads to adverse patient outcomes and increased healthcare costs.
Purpose of the Study:
- To evaluate the effectiveness of different PICC materials and designs in minimizing catheter failure and associated complications.
- To synthesize evidence from randomized controlled trials (RCTs) on PICC interventions.
Main Methods:
- Comprehensive search of multiple databases (Cochrane Vascular, MEDLINE, Embase, CINAHL) and trials registers.
- Inclusion of 12 RCTs with approximately 2913 participants, assessing PICC design and materials.
- Primary outcomes included VTE, BSI, occlusion, and mortality; secondary outcomes covered catheter failure, dwell time, and safety.
Main Results:
- Limited high-quality evidence exists, with most studies showing a high risk of bias.
- Integrated valve technology, anti-thrombogenic surface modification, and antimicrobial impregnation showed uncertain or little to no significant difference in reducing VTE, BSI, occlusion, or mortality.
- Evidence certainty was low to very low for most comparisons, highlighting significant uncertainty.
Conclusions:
- Current evidence on PICC materials and design is limited and of low quality, hindering informed clinical decision-making.
- There may be minimal to no difference in complication risks across various PICC types.
- Further high-quality RCTs are essential to reduce uncertainty and guide optimal PICC selection.
