Peripherally inserted central catheters in an acute-care hospital

Area of Science:

• Medical Devices
• Vascular Access
• Infectious Disease

Background:

• Peripherally inserted central catheterization (PICC) is an emerging intravenous therapy in acute-care settings.
• Limited research exists on PICC use in adult patients within acute-care environments.
• This study investigates the clinical outcomes and natural history of PICC utilization in a hospital setting.

Purpose of the Study:

• To evaluate the safety and efficacy of peripherally inserted central catheters (PICCs) in adult patients.
• To determine the complication rates associated with PICC insertion and use.
• To assess the natural history and outcomes of PICC utilization in an acute-care hospital.

Main Methods:

• Retrospective review of hospitalized patients who underwent PICC insertion between July 1991 and July 1992.
• Inclusion criteria: PICCs inserted, used, and removed during the same hospitalization.
• Data collected on catheter dwell time, reasons for removal, and complication rates.

Main Results:

• 135 PICCs were inserted in 114 adult patients; most (95.6%) were placed on general medical/surgical services.
• The average catheter dwell time was 14.1 days, with 46.7% removed after therapy completion.
• PICC-related infection rate was 2.2%; occlusion rates varied by gauge (20-gauge: 18.4%, 18-gauge: 8.2%).
• No significant difference in complication rates was observed based on catheter use (TPN vs. other) or between insertion/removal complications.

Conclusions:

• Peripherally inserted central catheters (PICCs) represent a safe and effective alternative to other central venous access devices.
• The convenience of PICCs for maintaining intravenous access in hospitalized patients makes them an attractive option.
• PICC utilization in acute-care settings is associated with a low incidence of serious complications.