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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Analysis of complications associated with peripherally inserted central venous catheters. Prospective observational
Marta Ferraz-Torres1, Ana Diez-Revilla2, Ruth Plaza-Unzue3
1PhD, MMCE, RN, University Hospital of Navarra, Navarra, Spain. Associate professor, Department of Health Sciences, Public University of Navarre, E-mail: marta.ferraz@unavarra.esResearcher, IdiSNA, Navarra Institute for Health Research Universidad de Navarra Department of Health Sciences Public University of Navarre Navarra Spain marta.ferraz@unavarra.es.
Insights
Vascular access teams effectively manage peripherally inserted central catheters (PICCs), achieving low complication rates, particularly in onco-hematological patients. Thrombosis and accidental removal were the most frequent complications observed.
Area of Science:
- Medical Devices
- Vascular Access
- Patient Care
Background:
- Vascular access teams utilize guidelines for device selection.
- Limited data exists on the performance of these specialized units.
- Peripherally inserted central catheters (PICCs) are common vascular access devices.
Purpose of the Study:
- To evaluate the complication rate of PICCs.
- To analyze the evolution and outcomes of PICCs in patients requiring vascular access.
Main Methods:
- Prospective observational study over three years.
- Statistical analysis included Student's t-test, Mann-Whitney U test, chi-square, and Fisher's exact test.
- Regression analysis was used to determine factors associated with complications.
Main Results:
- The most frequent complications were accidental removal (3.50%) and thrombosis (3%).
- Central line-associated bloodstream infection (CLABSI) occurred in 2.10% of cases.
- PICC dwell time averaged 136 days in oncologic patients and 144 days in hematologic patients.
Conclusions:
- PICC insertion and management by vascular access teams are associated with a low overall complication rate.
- Thrombosis and accidental removal are key complications to monitor.
- Specialized teams contribute to safe and effective PICC utilization in onco-hematological populations.
Introduction:
Vascular access teams often use guidelines or algorithms to determine the most appropriate vascular access device based on the patient's condition and the substance to be infused. These guidelines are intended to help identify the most qualified personnel for device insertion, but few studies collect information on the performance of these units.
Objective:
This study aims to identify the evolution and complication rate of peripherally inserted central catheters (PICCs) in patients requiring vascular access.
Materials And Methods:
A prospective observational study was conducted over three years. Continuous variables with normal distribution were compared using Student's t-test. Nonparametrically distributed variables were analyzed with the Mann-Whitney U test. For categorical variables, the two-tailed chi-square or Fisher's exact test was used. Regression analysis was performed for the dependent variable of complications.
Results:
Of the PICCs inserted, 61.99% (566) were in patients receiving oncologic treatment, with a mean dwell time of 136±127.51 days. PICCs inserted in hematologic patients had a mean dwell time of 144±141.3 days (p=0.438). The most frequent complications were accidental removal (3.50%, 32, OR 0.581), thrombosis (3%, 27, OR 0.752), and central line-associated bloodstream infection (CLABSI) (2.10%, 19, OR, 0.113).
Discussion:
Complications related to PICCs were infrequent, with thrombosis being the most prevalent. Accidental removal was also frequent, a complication not thoroughly analyzed in other studies.
Conclusions:
PICC insertion and management by vascular access teams enables units to achieve a low complication rate in onco-hematological patients.
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