PICCs more complicated than CVCs

December 18, 2011 by  
Filed under Acute Med, All Updates, ICU, Resus

A review showed that peripherally inserted central catheters were associated with higher rates of complications that standard central venous catheters


We undertook a review of studies comparing complications of centrally or peripherally inserted central venous catheters. Twelve studies were included. Catheter tip malpositioning (9.3% vs 3.4%, p = 0.0007), thrombophlebitis (78 vs 7.5 per 10 000 indwelling days, p = 0.0001) and catheter dysfunction (78 vs 14 per 10 000 indwelling days, p = 0.04) were more common with peripherally inserted catheters than with central catheter placement, respectively. There was no difference in infection rates. We found that the risks of tip malpositioning, thrombophlebitis and catheter dysfunction favour clinical use of centrally placed catheters instead of peripherally inserted central catheters, and that the two catheter types do not differ with respect to catheter- related infection rates.

Complications associated with peripheral or central routes for central venous cannulation
Anaesthesia. 2012 Jan;67(1):65-71

Comments

One Response to “PICCs more complicated than CVCs”

  1. Andrew Walker on December 18th, 2011 16:31

    These results make sense, in that you’d expect thrombophlebitis to be increased in smaller veins and catheter dysfunction to be greater in a longer line, but all complications would be expected to be greater in catheters which have been in for longer. Many of the PICC line “catheter days” would be > 2 weeks, compared to CVCs (at least the non-tunnelled variety). Another potential confounder is who’s looking after the line – you don’t need to be an ICU nurse to look after a PICC line (I known who I’d prefer to be looking after my line!).