A Randomized Trial of Complications of Peripherally and Centrally Inserted Central Lines in the Neuro-Intensive Care Unit: Results of the NSPVC Trial

Brandmeir, Nicholas; Davanzo, Justin R.; Payne, Russell; Sieg, Emily; Hamirani, Ashiya; Tsay, Annie; Watkins, Jeffrey N.; Hazard, Sprague W.; Zacko, J. Christopher

doi:10.1007/s12028-019-00843-z

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Figure 1 depicts the flowchart of the study selection process. Fifty eight non-comparative studies (2,5,7,10,11, included 103351 patients who underwent 109163 PICC insertions (Table 1), while seventeen comparative studies (74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90) with 5941 patients compared PICCs with CVCs (Table 2). For non-comparison studies, only thirteen provided data on anticoagulant prophylaxis for VTE prevention (Table 1).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

Puri

Dai

Giri

et al. 2022

Front. Cardiovasc. Med.

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BackgroundVenous thromboembolism (VTE) can be fatal if not treated promptly, and individual studies have reported wide variability in rates of VTE associated with peripherally inserted central catheters (PICC). We thus conducted this meta-analysis to investigate the overall incidence and risk of developing PICC-related VTE in hospitalized patients.MethodsWe searched PubMed, Embase, Scopus, and Web of Science databases from inception until January 26, 2022. In studies with a non-comparison arm, the pooled incidence of PICC-related VTE was calculated. The pooled odds ratio (OR) was calculated to assess the risk of VTE in the studies that compared PICC to the central venous catheter (CVC). The Newcastle-Ottawa Scale was used to assess methodological quality.ResultsA total of 75 articles (58 without a comparison arm and 17 with), including 109292 patients, were included in the meta-analysis. The overall pooled incidence of symptomatic VTE was 3.7% (95% CI: 3.1–4.4) in non-comparative studies. In the subgroup meta-analysis, the incidence of VTE was highest in patients who were in a critical care setting (10.6%; 95% CI: 5.0–17.7). Meta-analysis of comparative studies revealed that PICC was associated with a statistically significant increase in the odds of VTE events compared with CVC (OR, 2.48; 95% CI, 1.83–3.37; P < 0.01). However, in subgroup analysis stratified by the study design, there was no significant difference in VTE events between the PICC and CVC in randomized controlled trials (OR, 2.28; 95% CI, 0.77–6.74; P = 0.13).ConclusionBest practice standards such as PICC tip verification and VTE prophylaxis can help reduce the incidence and risk of PICC-related VTE. The risk-benefit of inserting PICC should be carefully weighed, especially in critically ill patients. Cautious interpretation of our results is important owing to substantial heterogeneity among the studies included in this study.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

Puri

Dai

Giri

et al. 2022

Front. Cardiovasc. Med.

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“…They are inserted via peripheral veins of the upper limb, with midlines terminating at or below the axillary vein, and PICCs having their tip at the cavoatrial junction, similar to CVLs. Compared with CVLs, PICCs are more prone to dislodgement, malfunction and risk of deep venous thrombosis (DVT) [3,9]. Compared with midlines, PICCs have a lower adjusted risk of DVT, but a higher risk of CRBSI and occlusion [10].…”

Section: Choice Of the Intravascular Accessmentioning

confidence: 99%

Update on prevention of intra-vascular accesses complications

2022

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“…[8] CVCs were used more frequently in intensive care unit (ICU) inpatients given their critical illness. [3,[9][10][11] Many studies on CRVT in ICU patients have been reported, and it has been found that venous catheter diameter, number of lumens, intubation site, blood transfusion, parenteral nutrition, sedation, and other factors are related to CVC-related thrombosis. [12][13][14] Critical and severe patients are usually treated in the ICU.…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study of disease-related risk factors for central venous catheter-related symptomatic thrombosis in intensive care unit inpatients

et al. 2021

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A Randomized Trial of Complications of Peripherally and Centrally Inserted Central Lines in the Neuro-Intensive Care Unit: Results of the NSPVC Trial

Cited by 11 publications

References 18 publications

The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis

Update on prevention of intra-vascular accesses complications

A retrospective cohort study of disease-related risk factors for central venous catheter-related symptomatic thrombosis in intensive care unit inpatients

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