Peripherally Inserted Central Catheter-associated Deep Vein Thrombosis: A Narrative Review

Fallouh, Nabil; McGuirk, Helen; Flanders, Scott A.; Chopra, Vineet

doi:10.1016/j.amjmed.2015.01.027

Cited by 115 publications

(122 citation statements)

References 99 publications

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“…PICC placement enables blood sampling and continuous vascular access without frequent venipunctures or direct cannulation of central veins, and these conveniences contribute to their expanding popularity (22,23). Because PICC use has increased, potential concerns about bloodstream infections, thromboses, and stenoses of central and peripheral veins have emerged (11)(12)(13)24,25).…”

Section: Discussionmentioning

confidence: 99%

“…Their use shortens the length of stay in hospitals and nursing facilities, and utilization has increased rapidly over the past 15 years (10,11). However, PICC use also is associated with stenosis, thrombosis, and obliteration of the central and peripheral veins in which they dwell (12,13), and these complications may have important long-term consequences for patients who subsequently require HD vascular access. Patients with CKD often have complex preexisting comorbid conditions that may result in PICC exposure, potentially increasing their risk for loss of veins (14).…”

Section: Introductionmentioning

confidence: 99%

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Peripherally Inserted Central Catheters and Hemodialysis Outcomes

McGill

Ruthazer²,

Meyer

et al. 2016

CJASN

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Background and objectives Use of peripherally inserted central catheters has expanded rapidly, but the consequences for patients who eventually require hemodialysis are undefined.Design, setting, participants, & measurements Our national, population-based analysis included 33,918 adult Medicare beneficiaries from the US Renal Data System who initiated hemodialysis with central venous catheters as their sole vascular access in 2010 and 2011. We used linked Medicare claims to identify peripherally inserted central catheter exposures and evaluate the associations of peripherally inserted central catheter placement with transition to working arteriovenous fistulas or grafts and patient survival using a Cox model with timedependent variables.Results Among 33,918 individuals initiating hemodialysis with a catheter as sole access, 12.6% had received at least one peripherally inserted central catheter. Median follow-up was 404 days (interquartile range, 103-680 days). Among 6487 peripherally inserted central catheters placed, 3435 (53%) were placed within the 2 years before hemodialysis initiation, and 3052 (47%) were placed afterward. Multiple peripherally inserted central catheters were placed in 30% of patients exposed to peripherally inserted central catheters. Recipients of peripherally inserted central catheters were more likely to be women and have comorbid diagnoses and less likely to have received predialysis nephrology care. After adjustment for clinical and demographic factors, peripherally inserted central catheters placed before or after hemodialysis initiation were independently associated with lower likelihoods of transition to any working fistula or graft (hazard ratio for prehemodialysis peripherally inserted central catheter, 0.85; 95% confidence interval, 0.79 to 0.91; hazard ratio for posthemodialysis peripherally inserted central catheter, 0.81; 95% confidence interval, 0.73 to 0.89).Conclusions Peripherally inserted central catheter placement was common and associated with adverse vascular access outcomes. Recognition of potential long-term adverse consequences of peripherally inserted central catheters is essential for clinicians caring for patients with CKD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peripherally Inserted Central Catheters and Hemodialysis Outcomes

McGill

Ruthazer²,

Meyer

et al. 2016

CJASN

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“…14 The use of computed tomography or magnetic resonance venography or contrast venography, the "gold standard," should be reserved for patients with a negative finding on duplex ultrasound examination but a high probability of UEDVT. 15 Testing for CA UEDVT should be reserved only for patients with the aforementioned symptoms or examination findings. There is no utility in screening patients with indwelling, functional catheters, even those with risk factors.…”

Section: Diagnosismentioning

confidence: 99%

Management of catheter-associated upper extremity deep venous thrombosis

Crawford

Liem

Moneta

2016

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…For example, PICCs and CVCs are associated with similar rates of infection 4,29,36 and with a high risk for deep vein thrombosis. 4,23 PVAD complications can interrupt or delay critical treatments; provoke pain and discomfort; reduce patient satisfaction; and result in suboptimal health care outcomes, injury, permanent disability, and death. 3 Complications may also necessitate more invasive and costly vascular access or require additional patient monitoring and therapies, contributing to additional avoidable costs in health care.…”

Section: Pvad Complications: General Considerationsmentioning

confidence: 99%

“…Venous thrombosis due to the presence of a venous access device 3 Inadvertent administration of a nonvesicant solution into subcutaneous tissue instead of the intended vascular route 3 Infiltration of a vesicant (an agent "capable of causing blistering, tissue sloughing, or necrosis") into subcutaneous tissue, instead of the intended vascular route and thrombosis 4,[19][20][21][22][23] and PVAD infiltration and extravasation 3,[24][25][26] is widely available. A review is provided in the sidebar Bloodstream Infection Associated With Short Peripheral Catheters.…”

Section: Definitionmentioning

confidence: 99%

Complications of Peripheral Venous Access Devices: Prevention, Detection, and Recovery Strategies

Mattox

2017

Critical Care Nurse

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Most hospitalized patients have placement of a peripheral venous access device, either a short peripheral catheter or a peripherally inserted central catheter. Compared with central venous catheters that are not peripherally inserted, the other 2 types are generally perceived by health care providers as safer and less complicated to manage, and less emphasis is placed on the prevention and management of complications. Expertise of nurses in inserting, managing, and removing these devices may reduce the likelihood of complications, and increased recognition of complications associated with use of the devices is important to ensure continued improvements in the safety, quality, and efficiency of health care. Complications associated with short peripheral catheters and peripherally inserted central catheters include tourniquet retention, tubing and catheter misconnections, phlebitis, air embolism, device fragment embolization, and inadvertent discharge with a retained peripheral venous access device. Integration of prevention, detection, and recovery strategies into personal nursing practice promotes the quality and safety of health care delivery.

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Peripherally Inserted Central Catheter-associated Deep Vein Thrombosis: A Narrative Review

Cited by 115 publications

References 99 publications

Peripherally Inserted Central Catheters and Hemodialysis Outcomes

Peripherally Inserted Central Catheters and Hemodialysis Outcomes

Management of catheter-associated upper extremity deep venous thrombosis

Complications of Peripheral Venous Access Devices: Prevention, Detection, and Recovery Strategies

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