Central Vascular Catheters versus Peripherally Inserted Central                     Catheters in Nurse Anesthesia. A Perspective within the Greek Health                     System

Konstantinou, Evangelos; Karampinis, Dimitrios F.; Mitsos, Aristotelis P.; Konstantinou, Maria; Mariolis‐Sapsakos, Theodoros; Kapritsou, Maria; Stafylarakis, Emmanouil; Κατσούλας, Θεόδωρος; Elefsiniotis, Ioannis

doi:10.5301/jva.5000160

Cited by 6 publications

(13 citation statements)

References 22 publications

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“…Across several studies, pain during catheter insertion was reported in 0% to 18% of patients using PICCs. [11][12][13][14][15] In the study by Konstantinou et al, 11 no significant difference was reported for pain during the procedure between PICCs and CICCs (7.7% vs. 12.2%, P = 0.502). In the study by Pedersen et al, 14 8.7% of patients with PICCs experienced pain during insertion, compared to 23.4% of patients with PIVC lines.…”

Section: Efficacy Outcomesmentioning

confidence: 88%

“…The study by Konstantinou et al 11 reported no significant difference between PICCs and CICCs (P = 0.18) in the number of venipunctures required for successful catheter insertion. However, fewer venipunctures were required with PICCs ver-sus PIVCs in the study by Periard at al 10 for initial catheter insertion (1.16 vs. 2.27, P < 0.01).…”

Section: Efficacy Outcomesmentioning

confidence: 92%

“…The reported mean catheter dwell time/duration ranged from 9.4 to 127 days with PICCs 6,10-12,15,16,18,22-35 versus 4.4 to 7.3 days with PIVCs 6,10 and 6.83 to 324.92 days with CICCs. 6,11,16,22,28,33 In 2 studies, mean catheter dwell time was significantly higher for PICCs versus CICCs (P < 0.0001), 11,16 whereas the opposite was true in 2 other studies (P < 0.001). 22,33 In the study by Periard et al 10 in patients requiring IV therapy for at least 5 days, mean catheter dwell time was significantly higher for PICCs compared to PIVCs (9.4 vs. 7.3 days, P = 0.01).…”

Section: Efficacy Outcomesmentioning

confidence: 95%

“…However, a higher CRBSI rate and a lower time to first CRBSI were reported for PICCs versus CICCs in a 6-year follow-up study in HPN patients (1.43 ± 0.20 vs. 0.95 ± 0.39 per 1000 catheter days, 83.91 ± 93.75 vs. 297.21 ± 386.91 days, P < 0.001). 22 Rates of bleeding complications (hematomas) with PICCs ranged from 0% to 8% of patients, 4,11,13,23,26,29,30,45 and a rate of 0% for local hematomas was reported with CICCs in a single study with no significant difference compared to PICCs (2.56%, P = 0.326). 11 Cost Outcomes Two studies met the study selection criteria and reported cost outcomes for PICCs and their comparators.…”

Section: Safety Outcomesmentioning

confidence: 97%

“…29 Infections in general (sepsis, local infections, and infections at insertion site) occurred in 0% to 21% of patients with PICCs [4][5][6]11,[13][14][15]18,23,26,27,33,35,37,44,[47][48][49] versus 0% to 14% with PIVCs 6,10,14 and 0% to 35% with CVCs. 5,6,11,33 In the study by Toure et al, 33 catheter-associated infection (exit site, tunnel, or pocket infection) rate was lower in patients receiving HPN by PICCs versus CICCs (1.05 vs. 1.87 per 1000 catheter days, P = 0.01). Rates of central line-associated bloodstream infections (CLABSI) with PICCs were 0% to 5.7%, 12,15,26,47 and CLABSI was not assessed in the studies of PICCs and CICCs.…”

Section: Safety Outcomesmentioning

confidence: 99%

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Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review

Mussa

Alsbrooks

Hutcheson³

2019

Journal of the Association for Vascular Access

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Section: Efficacy Outcomesmentioning

confidence: 88%

Section: Efficacy Outcomesmentioning

confidence: 92%

Section: Efficacy Outcomesmentioning

confidence: 95%

Section: Safety Outcomesmentioning

confidence: 97%

Section: Safety Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review

Mussa

Alsbrooks

Hutcheson³

2019

Journal of the Association for Vascular Access

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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

Schears

Ferko²,

Syed³

et al. 2020

J Vasc Access

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Background: Peripherally inserted central catheters and centrally inserted central catheters have numerous benefits but can be associated with risks. This meta-analysis compared central catheters for relevant clinical outcomes using recent studies more likely to coincide with practice guidelines. Methods: Several databases, Ovid MEDLINE, Embase, and EBM Reviews were searched for articles (2006–2018) that compared central catheters. Analyses were limited to peer-reviewed studies comparing peripherally inserted central catheters to centrally inserted central catheters for deep vein thrombosis and/or central line–associated bloodstream infections. Subgroup, sensitivity analyses, and patient-reported measures were included. Risk ratios, incidence rate ratios, and weighted event risks were reported. Study quality assessment was conducted using Newcastle–Ottawa and Cochrane Risk of Bias scales. Results: Of 4609 screened abstracts, 31 studies were included in these meta-analyses. Across studies, peripherally inserted central catheters were protective for central line–associated bloodstream infection (incidence rate ratio = 0.52, 95% confidence interval: 0.30–0.92), with consistent results across subgroups. Peripherally inserted central catheters were associated with an increased risk of deep vein thrombosis (risk ratio = 2.08, 95% confidence interval: 1.47–2.94); however, smaller diameter and single-lumen peripherally inserted central catheters were no longer associated with increased risk. The absolute risk of deep vein thrombosis was calculated to 2.3% and 3.9% for smaller diameter peripherally inserted central catheters and centrally inserted central catheters, respectively. On average, peripherally inserted central catheter patients had 11.6 more catheter days than centrally inserted central catheter patients ( p = 0.064). Patient outcomes favored peripherally inserted central catheters. Conclusion: When adhering to best practices, this study demonstrated that concerns related to peripherally inserted central catheters and deep vein thrombosis risk are minimized. Dramatic changes to clinical practice over the last 10 years have helped to address past issues with central catheters and complication risk. Given the lower rate of complications when following current guidelines, clinicians should prioritize central line choice based on patient therapeutic needs, rather than fear of complications. Future research should continue to consider contemporary literature over antiquated data, such that it recognizes the implications of best practices in modern central catheterization.

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Poland’s first vascular access team 3-year analysis: Insights and learnings

Latos,

Kosson,

Zawadka

2024

J Vasc Access

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Background: During the COVID-19 pandemic, Poland saw a surge in interest in midline catheters (MCs) and Long Peripheral Catheters (LPCs) for intravenous therapy. Before this, MCs were not extensively utilised in the country, and there was no formally established Polish vascular access team. MCs, which have been used for years in many countries, are now becoming increasingly common in Poland. This study aimed to analyse the use of MCs in a 3-year perspective of their introduction in daily clinical practice based on a nurse-led Vascular Access Team (VAT). Methods: The records of adult patients who received intravenous therapy with 727 MCs and 293 LPCs from January 2021 to December 2023 at the University Clinical Centre of the Medical University of Warsaw were analysed. Results: The main indication for cannulation was expected intravenous therapy over 5 days (81.66%, n = 833), of which 71.37% ( n = 728) of patients in this group had concomitant difficult intravenous access (DIVA). Over 6 years, centrally inserted central catheters (CICCs) inserted due to DIVA were reduced from n = 108 in 2017 to n = 18 in 2023. The end of intravenous therapy was the reason for the removal of 64.6% of catheters ( n = 659), including death and switch to CICCs as well. Complications leading to premature removal accounted for 31.2%, such as: occlusion (14.6%), patient self-removal (7.1%) and thrombosis (3.43%). Conclusions: The introduction of MCs as a possible option for peripheral venous access reduces the use of CVCs. Developing MCs programmes should be based on investing in staff competencies, which increases success rates. The nurses and physicians should be trained in infusion care to achieve better results in the use of MCs and LPCs. Increasing the competence of nurses in Poland is necessary for the implementation of full-service and top-level functioning of VAT.

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Central Vascular Catheters versus Peripherally Inserted Central Catheters in Nurse Anesthesia. A Perspective within the Greek Health System

Abstract: PICCs under ultrasound guidance constitute the solution of choice for patients and they definitely surpass the CVCs focusing mainly on the improvement of the quality of life and the satisfaction of patients.

Cited by 6 publications

References 22 publications

Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review

Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review

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

Poland’s first vascular access team 3-year analysis: Insights and learnings

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