Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study

Abstract

Background and AimThe use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients.Materials and MethodsIn this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis.ResultsAll patients were treated according to the same “nursing care” protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to “end of treatment” (48.42%) and “exitus”, (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%).ConclusionsPICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant.

Central Line Catheters and Associated Complications: A Review

“…The above figure is a photograph of a patient's cubital fossa showing the insertion site of a peripherally inserted central catheter (PICC) [6]. …”

Living with a peripherally inserted central catheter: the perspective of cancer outpatients—a qualitative study

“…To access the reservoir, a needle is inserted through the skin to the septum of the port [ 7 ]. The use of PICC is generally advisable in the following cases: patients with cancer and who have limited peripheral venous access, patients receiving regimes requiring prolonged or continuous intravenous infusions of multiple chemotherapeutic or supportive care agents, patients requiring repeated blood draws or clinical monitoring, and patients who expect to receive a vesicant agent as part of their treatment regimen [ 7 , 12 – 14 ]. It is indicated in the absence of peripheral venous access or when it is severely damaged due to treatment or multiple venipunctures [ 15 ].…”

“…Using a PICC, the risk of extravasation is markedly reduced, which is particularly relevant for the administration of vesicant or irritating cytostatics [ 16 ]. In addition, although PICC lines are not exempted from complications, these are small in magnitude [ 12 ].…”

The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit

“…Central venous catheters (CVCs) are widely used in clinical setting due to their functional roles in intravenous treatments, laboratory testing, and hemodynamic monitoring 1 . Peripherally inserted central catheter (PICC), a specialized CVC, play an important role in treatment of hospitalized patients, especially intensive care unit (ICU) patients 2 .…”