Feasibility of Bedside Ultrasound-Guided Peripherally Inserted Central Catheter Placement in Cancer Patients in...

Background and Objectives: Some cancer patients in palliative care need to access intravenous administration of medications to relieve symptoms. Few studies have explicitly assessed the safety and feasibility of peripherally inserted central catheter (PICC) insertion at bedside in palliative care settings. In this study, we suggest the usefulness, safety, and feasibility of bedside ultrasound-guided PICC placement as a tool for improvement in the quality of life for patients in palliative and hospice care settings. Materials and Methods: The study population, with terminal cancer and admitted to a palliative and hospice care unit in the Veterans Health Service Medical Center, was evaluated (N = 150). The patients were divided into two groups based on the methods of PICC insertion: Group 1 (PICC at bedside, N = 75) and Group 2 (PICC in intervention room, N = 75). The two groups were matched for age, sex, the level of Eastern Cooperative Oncology Group (ECOG) performance status, and types of primary cancer. Results: The success rates of the PICC procedure for Groups 1 and 2 were 89.33% and 97.33%, respectively, with no significant difference between the groups (p = 0.102). The mean duration (days) of catheter use was longer in Group 1 (23.31 ± 16.36) compared to that in Group 2 (21.90 ± 18.95), with no statistically significant difference (p = 0.639). Multivariable logistic regression analyses confirmed that Group 1 was not inferior to Group 2 regarding procedural success (Model 2, p = 0.21) and catheter dwell time (Model 2, p = 0.66). The most common cause of catheter removal in both groups was death, followed by self-removal and hospital discharge (p = 0.386). Conclusions: This study suggests that ultrasound-guided PICC insertion at bedside may have comparable procedural outcomes with potentially reducing the risks associated with intra-hospital patient transport compared with fluoroscopy-guided placement. We suggest this bedside approach can be considered a feasible and safe method for improving the quality of life of patients in palliative care settings.