PERIPHERALLY INSERTED CENTRAL CATHETERS IN AN ACUTE-CARE HOSPITAL

Background: Peripherally inserted central catheterization is a relativ ely new approach for intravenous therapy in acute-care hospitals. Few studies are available on peripherally inserted central catheters (PICC s) used in adult patients in an acute-care setting. We examine the nat ural history and outcome of PICC use in our hospital. Methods: A retro spective review was undertaken of all hospitalized patients who had PI CCs inserted in an acute-care, metropolitan teaching hospital for any reason from July 1991 through July 1992. Patients who had PICCs insert ed, used, and then removed in the same hospitalization were evaluated. Results: A total of 135 PICCs were inserted in 114 patients. Six PICC s (4.4%) were inserted in intensive care unit settings and 129 (95.6%) in general medical or surgical service. The mean duration,catheters w ere in place before removal was 14.1 days. Sixty-three catheters (46.7 %) were removed following completion of therapy. The rate of PICC-rela ted infection was 2.2% (three catheters). The occlusion rate was highe r for 20-gauge catheters (18.4%) than for 18-gauge catheters (8.2%) (P =.08). When the rate of complications was compared as a function of ca theter use (total parenteral nutrition vs any other use), there was no statistically significant difference (P=.12). Overall complications r elated to catheter insertion and removal were uncommon. Conclusions: B ased on our study, we conclude that the PICC provides a reasonable and safe alternative to other centrally placed venous devices. In additio n, the convenience of maintaining a PICC compared with peripheral intr avenous access makes this an attractive method for in-hospital use.