Peripherally Inserted Central Catheters (PICCs) in CKD: PICC’ing the Best Access for Kidney Disease Patients

Drew, David A.; Weiner, Daniel E.

doi:10.1053/j.ajkd.2016.01.013

Cited by 5 publications

(1 citation statement)

References 12 publications

(11 reference statements)

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“…Although they are relatively easy to place and inexpensive, PICC line use is associated with many complications such as phlebitis/thrombophlebitis, venous thrombosis, catheter-related infection, wound infection, and central vein stenosis. 29,30 Importantly, the complications of PICC lines are more deleterious for patients with chronic kidney disease (CKD) whose lives depend on a functioning hemodialysis access once they reach end stage kidney disease (ESKD). As per guidelines published by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI), upper extremity veins suitable for future vascular access placement should be preserved.…”

Section: Introductionmentioning

confidence: 99%

PICC line management among patients with chronic kidney disease

Oza-Gajera

Davis²,

Farrington

et al. 2021

J Vasc Access

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More than 1 million peripherally inserted central catheters (PICC) are placed annually in the US and are used to provide convenient vascular access for a variety of reasons including long term antibiotic treatment, chemotherapy, parenteral nutrition, and blood draws. Although they are relatively easy to place and inexpensive, PICC line use is associated with many complications such as phlebitis/thrombophlebitis, venous thrombosis, catheter-related infection, wound infection, and central vein stenosis. These complications are far more deleterious for patients with chronic kidney disease (CKD) whose lives depend on a functioning hemodialysis access once they reach end stage kidney disease (ESKD). Despite recent guidelines to avoid PICC lines in CKD and ESKD patients, clinical use remains high. There is an ongoing urgency to educate and inform health care providers and the CKD patients themselves in preserving their venous real estate. In this article, we review AV access and PICC line background, complications associated with PICC lines in the CKD population, and recommendations for alternatives to placing a PICC line in this vulnerable patient population.

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Section: Introductionmentioning

confidence: 99%

PICC line management among patients with chronic kidney disease

Oza-Gajera

Davis²,

Farrington

et al. 2021

J Vasc Access

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Prevention of Central-Line Associated Bloodstream Infections

Selby

Rupp

Cawcutt

2021

Infectious Disease Clinics of North America

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End‐stage renal disease in a critical patient with superior vena cava syndrome with central vein catheters inserted via the superficial femoral vein: A case study

Yu,

Gao,

Zhao

et al. 2024

Nursing in Critical Care

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Superior vena cava syndrome (SVCS) is caused by obstruction to the blood flow through this vein. Indwelling central venous devices, such as cardiac pacemakers and haemodialysis catheters have emerged as the most common benign aetiology of SVCS. SVCS is particularly severe in patients with end‐stage renal disease who require continuous renal replacement therapy plus infusion therapy. The presence of SVCS results in a reduction of available venous access for affected patients. Therefore, venous access plays a crucial role in the management of these patients. The importance of dealing with vascular access (VA) in critical patients with these conditions cannot be overstated. This case describes an 81‐year‐old man with respiratory failure who had end‐stage renal disease complicated with SVCS. Using ultrasound‐guided puncture, we inserted a peripherally inserted central catheter (PICC) into the superficial femoral vein to meet his infusion requirements in intensive care. After successful placement, the catheter tip position was adjusted using imaging to position the tip relative to the haemodialysis catheter. Whenever patients with severe renal dysfunction are treated, central veins should be preserved. Safe PICC access is possible via the superficial femoral vein to protect the last central VA for rational use. This meets urgent needs for infusion and deserves promotion.

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Peripherally Inserted Central Catheters (PICCs) in CKD: PICC’ing the Best Access for Kidney Disease Patients

Cited by 5 publications

References 12 publications

PICC line management among patients with chronic kidney disease

PICC line management among patients with chronic kidney disease

Prevention of Central-Line Associated Bloodstream Infections

End‐stage renal disease in a critical patient with superior vena cava syndrome with central vein catheters inserted via the superficial femoral vein: A case study

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