A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies

Abstract

Central venous catheter-related blood stream infections (CR-BSIs) are a serious complication in patients with hematological malignancies. However, it remains unclear whether there is a difference in the rate of CR-BSI associated with the conventional type of central venous catheters (cCVCs) and peripherally inserted CVCs (PICCs) in such patients. To address this question, we retrospectively investigated the incidence of CR-BSIs associated with PICCs versus cCVCs in patients with hematological malignancies. We used PICCs in all consecutive patients requiring CVC placement between February 2009 and February 2013. We compared the CR-BSI rate in patients with PICCs with that in patients with cCVCs treated between September 2006 and January 2009 (control group). Eighty-four patients received PICCs and 85 received cCVCs. The most common reason for removal due to catheter-related complications was CR-BSI. The CR-BSI rate in the PICC group was significantly lower than that in the cCVC group (PICCs: 1.23/1000 catheter days; cCVCs: 5.30/1000 catheter days; P < 0.01). Catheter-related complications other than CR-BSIs occurred at an extremely low rate in the PICC group. The median catheter-related complication-free survival duration was significantly longer in the PICC group than in the cCVC group. Our study shows that PICCs are useful in patients with hematological malignancies.

ECO-SEOM-SEEO safety recommendations guideline for cancer patients receiving intravenous therapy

“…Infections are one of the most serious complications to consider among cancer patients, owing to both the treatment and malignancy conditions of the disease [24] and the conditions related to the venous access itself [20]. Regarding their incidence according to the type of central access used, the evidence is still controversial, as some studies performed in cancer patients showed significantly lower rates with PICCs versus CICCs (1.23 vs. 5.3/100 days of catheter use) [25] or a lower incidence with PICCs in outpatients [26], while other data suggest that in the short term the incidence of infection is similar.…”

Peripherally inserted central catheters inserted with current best practices have low deep vein thrombosis and central line–associated bloodstream infection risk compared with centrally inserted central catheters: A contemporary meta-analysis

“…2 Both catheter types terminate in the junction between the superior vena cava (SVC) and atrium of the heart. 2,3 PICCs and CICCs, each having unique benefits, are commonly used to deliver medication in various settings and patient populations, including intensive care units (ICUs), 4–7 for oncology patients, 1,8–10 and in-home parenteral nutrition (HPN). 8,11 These can be used for both short- and long-term venous access.…”

Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

“…In addition to CRBSI, the rate of PICC‐related thrombosis exhibited a statistically significant decrease over the last decades. Less than 7% of PICC‐related thrombosis incidence rate was reported in several recent studies (Chopra, Kuhn, Ratz, Lee, & Krein, ; Patel et al., ; Sakai et al., ). Nevertheless, researches have demonstrated a correlation between deep vein thrombosis and malignancies (Chopra, Anand, et al., ; Fallouh, McGuirk, Flanders, & Chopra, ; Hingorani et al., ), which is consistent with our results of apparently higher incidence rate of PICC‐related thrombosis.…”

“…Additionally, 11.4% of patients had a PICC‐related thrombosis in our study. The previous study on nonhospitalised cancer patients showed a thrombosis rate of 1.1%, whereas another study reported that 8.9% of patients with haematological malignancies developed CRBSI (Cotogni et al., ; Sakai et al., ). This difference may suggest that PICC‐related thrombosis is more prevalent in haematological malignancies than solid tumours.…”