Complications and Risk Factors of Peripherally Inserted Central Catheters: A Review

Abstract

Peripherally inserted central catheters (PICCs) are widely used in cancer and critical patients for it's convenience and performance compared to central venous catheters (CVCs), however, PICCs are still associated with some complications which increase disease burden and health care cost. No agreement about incidence and risk factors of PICC-related complications has reached from previous studies although much work has been done in this area. Lack of targeted prevention may lead to difficulties and stagnation in prevention of PICC-related complications. Our review reviewed current literatures on PICC-related complications and risk factors aiming to provide reference for further PICC research and prevention measures. In this review, we searched PICC relate literatures, and listed the incidence and risk factors of PICC-related complications. Different studies reported different data and risk factors, and we have detailed in this review. The total incidence rate of complications ranged from 3% to 61.67%, infection and venous thrombosis are the most two common complications. The risk factors varied from study to study, but it is basically divided into patient related-, operation related-and material related-. For the prevention measures, we considered standardized operation and nursing according to guidance played an important role. In this field, better research and conclusions are needed to guide the work of medical staff.

Integrative Review: Complications of Peripherally Inserted Central Catheters (PICC) and Midline Catheters with Economic Analysis of Potential Impact of Hydrophilic Catheter Material

“…Catheter complication risk increases with poor hygienic practices, patient factors, skin, breaks in sterile technique, multiple attempts with traumatic insertions, various forms of contamination, and from lack of attention to maintenance practices [90,93,94]. Factors known to reduce complications include education and training, use of checklists, bundled practices, antimicrobial devices, disinfecting caps, and infection prevention practices [95]. With the numerous prevention strategies employed to reduce the incidence of infection and thrombosis, catheter materials are rarely mentioned other than with additional approaches for using surface modified antimicrobial or impregnated catheters [96].…”

“…Biocompatibility of the material, which may prevent a foreign body response, is most successfully achieved with hydrophilic material interface between the catheter surface and the tissue reaction making the material inherently inert and closely mimicking the blood chemistry [98]. Silicone catheters have a higher risk of microorganism colonization and infection, while polyurethane catheter risk of thrombosis and occlusion are higher, with neither demonstrating physical properties of lubricity or wettability with water absorption [95,99,100]. Prevention of thrombosis, infection and catheter occlusion are high priorities for maintaining catheter function for infusion of prescribed treatment.…”