Peripherally Inserted Central Catheters and Nontunneled Central Venous Catheters

2020 ◽  
pp. 669-676.e2
Author(s):  
Jennifer L. Kissane ◽  
Joseph A. Hughes ◽  
Colin P. Cantwell ◽  
Peter N. Waybill
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

The Risk of Bloodstream Infection Associated with Peripherally Inserted Central Catheters Compared with Central Venous Catheters in Adults: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 34 (9) ◽  
pp. 908-918 ◽  
Author(s):  
Vineet Chopra ◽  
John C. O'Horo ◽  
Mary A. M. Rogers ◽  
Dennis G. Maki ◽  
Nasia Safdar
Keyword(s):  
Bloodstream Infection ◽  
Lower Risk ◽  
Central Venous Catheters ◽  
Hospitalized Patients ◽  
Central Venous ◽  
Eligibility Criteria ◽  
Peripherally Inserted Central Catheters ◽  
Statistical Heterogeneity ◽  
Meta Analyses ◽  
Central Catheters

Background.Peripherally inserted central catheters (PICCs) are associated with central line-associated bloodstream infection (CLABSI). The magnitude of this risk relative to central venous catheters (CVCs) is unknown.Objective.To compare risk of CLABSI between PICCs and CVCs.MethodsMEDLINE, CinAHL, Scopus, EmBASE, and Cochrane CENTRAL were searched. Full-text studies comparing the risk of CLABSI between PICCs and CVCs were included. Studies involving adults 18 years of age or older who underwent insertion of a PICC or a CVC and reported CLABSI were included in our analysis. Studies were evaluated using the Downs and Black scale for risk of bias. Random effects meta-analyses were used to generate summary estimates of CLABSI risk in patients with PICCs versus CVCs.Results.Of 1,185 studies identified, 23 studies involving 57,250 patients met eligibility criteria. Twenty of 23 eligible studies reported the total number of CLABSI episodes in patients with PICCs and CVCs. Pooled meta-analyses of these studies revealed that PICCs were associated with a lower risk of CLABSI than were CVCs (relative risk [RR], 0.62; 95% confidence interval [CI], 0.40-0.94). Statistical heterogeneity prompted subgroup analysis, which demonstrated that CLABSI reduction was greatest in outpatients (RR [95% CI], 0.22 [0.18-0.27]) compared with hospitalized patients who received PICCs (RR [95% CI], 0.73 [0.54-0.98]). Thirteen of the included 23 studies reported CLABSI per catheter-day. Within these studies, PICC-related CLABSI occurred as frequently as CLABSI from CVCs (incidence rate ratio [95% CI], 0.91 [0.46-1.79]).Limitations.Only 1 randomized trial met inclusion criteria. CLABSI definition and infection prevention strategies were variably reported. Few studies reported infections by catheter-days.Conclusions.Although PICCs are associated with a lower risk of CLABSI than CVCs in outpatients, hospitalized patients may be just as likely to experience CLABSI with PICCs as with CVCs. Consideration of risks and benefits before PICC use in inpatient settings is warranted.

Assessing the Quality of Central Venous Catheter and Peripherally Inserted Central Catheter Videos on the YouTube Video-Sharing Web site

2013 ◽  
Vol 18 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Peter J. Carr ◽  
Evan Alexandrou ◽  
Gavin M. Jackson ◽  
Timothy R. Spencer
Keyword(s):  
Venous Catheter ◽  
Central Venous Catheters ◽  
Evidence Based ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Video Sharing ◽  
Evidence Based Guidelines ◽  
Central Catheters

AbstractBackground: Video sharing networks such as YouTube have revolutionized communication. Whilst access is freely available uploaded videos can contain non peer-reviewed information. This has consequences for the scientific and health care community, when the challenge in teaching is to present clinical procedures that follow empirical methods.Objective: To review 50 central venous catheter and peripherally inserted central catheter videos posted on YouTube. The aim was to appraise these videos using current evidenced-based guidelines.Methods: We searched YouTube using the key words central venous cannulation and peripherally inserted central catheter insertion on September 21, 2012. We consecutively reviewed 50 videos for both procedures.Results: There was poor adherence to evidence-based guidelines in the critiqued videos. There was a difference in adherence with the use of appropriate skin antisepsis in the 2 groups (18% for central venous catheters vs 52% for peripherally inserted central catheters; p = 0.009). And a large proportion in both groups compromised aseptic technique (37% for central venous catheters vs 38% for peripherally inserted central catheter; p = 0.940). The use of ultrasound guidance during procedures was also different between the 2 groups (33% for central venous catheters vs 85% for peripherally inserted central catheters; p = 0.017).Conclusions: This critique of instructional videos related to the insertion of central venous catheters and peripherally inserted central catheters uploaded to YouTube has highlighted poor adherence to current evidence-based guidelines. This lack of adherence to empirical guidelines can pose risks to clinical learning and ultimately to patient safety.

Use of Peripherally Inserted Central Catheters As an Alternative to Central Catheters in Neurocritical Care Units

2011 ◽  
Vol 31 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Christi DeLemos ◽  
Judy Abi-Nader ◽  
Paul T. Akins
Keyword(s):  
Critical Care ◽  
Subarachnoid Hemorrhage ◽  
Pulmonary Artery ◽  
Neurocritical Care ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Pulmonary Artery Catheters ◽  
Central Catheters ◽  
Neurological Critical Care

Background Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings. Methods Data on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage. Results Complete data were available on 33 patients with Hunt-Hess grade IV–V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 days (mean, 19 days; range, 4–64 days). One patient (3%) had deep vein thrombosis in an upper extremity. In 2 patients, central venous pressure measured with a peripherally inserted catheter was higher than pressure measured concurrently with a central venous catheter. None of the 33 patients had a central catheter bloodstream infection or persistent insertion-related complications. Conclusions Use of peripherally inserted central catheters rather than central venous catheters or pulmonary artery catheters in the neurocritical care unit reduced procedural and infection risk without compromising patient management.

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