Peripherally inserted central catheters (PICCs) in cancer patients under chemotherapy: A prospective study on the incidence of complications and overall failures

Bertoglio, Sergio; Faccini, Beatrice; Lalli, Luca; Cafiero, Ferdinando; Bruzzi, Paolo

doi:10.1002/jso.24220

Cited by 109 publications

(163 citation statements)

References 34 publications

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“…Differently from previous authors , in this study, PICC‐related symptomatic thrombosis was the AE with the lowest incidence (0.15 per 1,000 PICC‐days). This can be explained by the consistent choice of deep veins of the upper midarm (mainly the basilic vein) with an appropriate vessel‐to‐catheter ratio (at least 3:1) and the prevalent use of a PICC with a small diameter.…”

Section: Discussioncontrasting

confidence: 99%

“…Rates of PICC removal due to exit‐site infection (3.2% with a ratio of 0.21 per 1,000 PICC‐days) were in agreement with previous literature (2.2% with a ratio of 0.11 per 1,000 PICC‐days), although rates for PICC removal due to exit‐site infection as high as 1.46 per 1,000 catheter‐days have been registered .…”

Section: Discussionsupporting

confidence: 91%

“…Consistent with the literature , the basilic vein was most often used. The cephalic and brachial veins were cannulated in only one‐fourth of patients.…”

Section: Discussionmentioning

confidence: 61%

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Can Peripherally Inserted Central Catheters Be Safely Placed in Patients with Cancer Receiving Chemotherapy? A Retrospective Study of Almost 400,000 Catheter-Days

Campagna¹,

Gonella

Berchialla

et al. 2019

The Oncologist

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Background Peripherally inserted central catheters (PICCs) are central venous catheters (CVCs) that are commonly used in onco‐hematologic settings for chemotherapy administration. As there is insufficient evidence to recommend a specific CVC for chemotherapy administration, we aimed to ascertain PICC‐related adverse events (AEs) and identify independent predictors of PICC removal in patients with cancer receiving chemotherapy. Materials and Methods Information on adult patients with cancer with a PICC inserted for chemotherapy administration between September 2007 and December 2014 was extracted from six hospital databases. The primary outcome was PICC removal due to PICC‐related AEs (occlusion, infection, or symptomatic thrombosis). Independent predictors of PICC removal were identified using a multivariate Cox regression model. Results Among the 2,477 included patients, 419 PICC‐related AEs (16.9%; 1.09 AEs per 1,000 PICC‐days) were reported. AEs increased when PICC was inserted at the brachial site (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.02–1.84) and with open systems (HR, 1.89; 95% CI, 1.24–2.88) and decreased in older men (HR, 0.63; 95% CI, 0.49–0.81). Conclusion Use of PICC for chemotherapy administration was associated with a low all‐AEs rate. The basilic vein was the safer site, and valved systems had fewer AEs than open systems. More research is needed to explore the interaction between AEs, sex, and age. Implications for Practice These findings provide clinicians with evidence that peripherally inserted central catheters (PICCs) are safe for chemotherapy administration. They also suggest that clinicians should limit the use of open systems when long chemotherapy regimens are scheduled. Moreover, alternatives to PICCs should be considered when administering chemotherapy to young men.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 91%

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Can Peripherally Inserted Central Catheters Be Safely Placed in Patients with Cancer Receiving Chemotherapy? A Retrospective Study of Almost 400,000 Catheter-Days

Campagna¹,

Gonella

Berchialla

et al. 2019

The Oncologist

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“…Furthermore, PICCs are also easy to remove and less expensive than some other devices 4, 5 . However, PICCs have their own risks, such as infection, phlebitis and thrombosis 6 . In recent years, ultrasound technology combined with the Seldinger technique for PICCs has been found to increase the chance of success of PICC puncture and decrease the chance of complications 7 .…”

Section: Introductionmentioning

confidence: 99%

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Hao

Xie

Zhou

et al. 2017

Sci Rep

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The use of peripherally inserted central catheters (PICCs) is increasing rapidly worldwide. A number of patient-related, clinical-related and device-related characteristics might be risk factors for PICC-related thrombosis. We retrospectively reviewed a database of 320 consecutive patients who underwent PICC insertion between December 2014 and December 2015 at the First Affiliated Hospital of Xi’an Jiaotong University to explore the potential associations between risk factors and PICC-associated thrombosis. A novel nomogram for predicting risk was developed based on the data. The nomogram prediction model included ten risk factors that were derived from different relevant estimates. The nomogram prediction model showed good discriminatory power (Harrell’s C-index, 0.709) and a high degree of similarity to actual thrombosis occurring after calibration. Furthermore, principal component analysis was performed to identify the factors that most influence PICC-related thrombosis. Our novel nomogram thrombosis risk prediction model was accurate in predicting PICC-related thrombosis. Karnofsky performance scores, D-dimer and blood platelet levels and previous chemotherapy were principal components. Our findings might help clinicians predict thrombosis risk in individual patients, select proper therapeutic strategies and optimize the timing of anticoagulation therapy.

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“…The central venous port has grown in importance in cancer centers because of its advantages over central venous catheters, including the reduction of contamination of the device by external or skin pathogens, with an incidence of port‐related infection that varies between 0.9% and 5.4% . Compared with the incidence of CLABSI for tunneled lines (hazard ratio, 1.77; P ≤ .011), nontunneled central venous catheters have a higher incidence of infection (hazard ratio, 3.50; P < .0001), with the exception of peripherally inserted central catheters, in which the incidence rate of infection has been low, between 0.5 and 0.95 per 1000 catheter‐days …”

Section: Preventing Infectionmentioning

confidence: 99%

Update on infection control practices in cancer hospitals

Ariza-Heredia

Chemaly

2018

CA A Cancer J Clinicians

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Therapies in oncology have evolved rapidly over the last years. At the same pace, supportive care for patients receiving cancer therapy has also evolved, allowing patients to safely receive the newest advances in treatment in both an inpatient and outpatient basis. The recognition of the role of infection control and prevention (ICP) in the outcomes of patients living with cancer has been such that it is now a requirement for hospitals and involves multidisciplinary groups. Some unique aspects of ICP for patients with cancer that have gained momentum over the past few decades include catheter-related infections, multidrug-resistant organisms, community-acquired viral infections, and the impact of the health care environment on the horizontal transmission of organisms. Furthermore, as the potential for infections to cross international borders has increased, alertness for outbreaks or new infections that occur outside the area have become constant. As the future approaches, ICP in immunocompromised hosts will continue to integrate emerging disciplines, such as antibiotic stewardship and the microbiome, and new techniques for environmental cleaning and for controlling the spread of infections, such as whole-genome sequencing. CA Cancer J Clin 2018;000:000-000. © 2018 American Cancer Society.

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Peripherally inserted central catheters (PICCs) in cancer patients under chemotherapy: A prospective study on the incidence of complications and overall failures

Abstract: PICC is a safe venous device for chemotherapy delivery. Nevertheless, a 15% rate of failure has to be taken in account when planning PICC insertion for chemotherapy purposes. J. Surg. Oncol. 2016;113:708-714. © 2016 Wiley Periodicals, Inc.

Cited by 109 publications

References 34 publications

Can Peripherally Inserted Central Catheters Be Safely Placed in Patients with Cancer Receiving Chemotherapy? A Retrospective Study of Almost 400,000 Catheter-Days

Can Peripherally Inserted Central Catheters Be Safely Placed in Patients with Cancer Receiving Chemotherapy? A Retrospective Study of Almost 400,000 Catheter-Days

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Update on infection control practices in cancer hospitals

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