Peripherally inserted central catheter design and material for reducing catheter failure and complications

Abstract

7. Art. No.: CD013366. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

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

“…Polyurethane catheter materials, while also subject to fibrin sheath formation and embedded bacteria deposits, are available as segmented urethanes with hard and soft segments of diisocyanates and polyethers, and carbonate copolymers [53,63,64] and chemical properties within catheter products [53,55]. Optimal features include high tensile strength, soft pliable durometer, high biocompatibility, long-term dwell, chemical resistance, and ability to maintain adequate flow with thin walls and smallest diameter [53,68].…”

“…A hydrophobic or rougher surface attracts platelet adhesion, adsorbing fibrinogen [63]. As a result, catheters prepared from these materials are prone to various failure modes such as thrombosis and thrombotic occlusion [67,68]. According to Mehall et al blood adherence to a catheter, forming a fibrin sheath, most commonly around the external catheter, promotes trapping of bacteria and colonization, enhancing the risk of catheter associated infection [63].…”

Antibiofilm and antithrombotic hydrogel coating based on superhydrophilic zwitterionic carboxymethyl chitosan for blood-contacting devices

“…Peripherally inserted central catheters (PICCs), one of the most commonly used blood-contacting cardiovascular devices, are used primarily in persons who require prolonged intravascular therapy, such as total parenteral nutrition, chemotherapy regimens, and antibiotic therapy [ 3 ]. PICCs can remain inserted into the basilic, brachial, or cephalic veins of the arm for an extended therapy period (days or weeks) [ 4 ]. The prolonged insertion increases the risk of acute infections and thrombosis, rendering PICCs susceptible to catheter-associated bloodstream infections (CABSI) or thrombi with blood clotting [ 3 , 5 ].…”

The Effect of Implementing Peripherally Inserted Central Catheter Educational Program on Nurses ‘Knowledge, Practice, and Neonatal Outcomes

“…In addition to its safety (insertion), its non-surgical procedure, local use of anesthesia, presents a low risk of causing drugs' infiltration or chemical phlebitis, and allows the administration of high pH, vesicant, and hyperosmolar solutions (Schults, et al 2019).…”