Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Review

Volume 11, Number 4, April 2019, pages 237-246

Peripheral Inserted Central Catheter Use and Related Infections in Clinical Practice: A Literature Update

Figure

Figure 1.
Figure 1. Literature search method.

Table

Table 1. Literature Retrieved
 
Study and yearStudy designType of patients/databaseMajor findings
Santolim et al, 2018, [4]Retrospective study from a single-centerPatients from Orthopedics and Traumatology DepartmentAfter insertion of 720 PICCs, no cases of PICC line infections were documented after culture of samples from catheter tips and peripheral blood.
Kim et al, 2018, [5]Multi-center retrospective studyAdult patients with tunneled or conventional PICCsReduction rate of CLABSI related to subcutaneous tunneling approach for PICC placement
Kagan et al, 2018, [6]Retrospective studyAdult ill populationPICC CLABSIs were highest among patients receiving non-antimicrobial-impregnated (NAIP) catheters.
Stewart et al, 2018, [7]Retrospective studyPatients with Staphylococcus aureus bacteremiaEarly PICC line insertion in Staphylococcus aureus bacteremia appears to be safe.
Herc et al, 2017, [8]Study based on data from the Michigan Hospital Medicine Safety consortiumAdult patientsThe Michigan PICC-CLABSI (MPC) offers a novel way to inform decisions regarding PICC use, surveillance of high-risk cohorts, and utility of blood cultures when PICC-CLABSI is suspected.
Martyak et al, 2017, [9]Retrospective reviewPatients with PICCs inserted by the bedside in the ICU and PICCs placed by interventional radiology in non-ICUPICC lines placed at the bedside in the ICU setting were associated with higher complication rates, in particular infectious complications.
Lo Priore et al, 2017, [10]Retrospectively collected dataMainly oncology patientsDecreased infectious rate after implementing a systematic surveillance program
Chaftari et al, 2017, [11]Prospective single institution studyPatients with hematologic malignanciesNon-antibiotic catheter lock solution with nitroglycerin, ethanol and sodium citrate reduced CLABSI.
Jacques et al, 2018, [12]Retrospective case seriesPregnant and postpartum patientsNo differences in infectious rate compared to non-pregnant
Kang et al, 2017, [13]Prospective, multi-center, cohort studyCancer patientsCLABSI rate 1.3%. Increased MBI was related to more complications.
Chen et al, 2017, [14]Retrospective studyAcute myeloid leukemia patientsBacteremia in patients with PICCs was comparable to that of other IV lines.
Xu et al, 2016, [15]Retrospective studyPatients from a large academic medical centerPICCs complications were less but more serious (including bacteremia) when compared to midline peripheral catheters
Kim-Saechao, et al, 2016, [16]Historical cohort studyPatients in an academic tertiary medical centerApplication of a mandatory electronic communication tool (MECT) based on clinical practice guidelines decreased CLABSI.
Storey et al, 2016, [17]Randomly assignment of patientsPatients in three high-risk unitsNo differences in CLABSI development in patients with chlorhexidine (CHG)-impregnated or non-CHG PICC line
Pernar et al, 2016, [18]Retrospective review of prospectively collected dataPatients’ requests for PICCs maintained in database (2000-13)Implementation of a surgeon-led PICC team had among other, significant impact on the avoidance of complications of PICC lines.
Bertoglio et al, 2016, [19]Prospective studyOncology patientsPICC is a safe venous device for chemotherapy delivery with CLABSI incidence 1.7%.
Nolan et al, 2016, [20]Retrospective cohort studyAdult ITU patientsPICCs (dual/triple lumen) and centrally inserted central catheter CICCs (triple/quadruple lumen) were compared for complications of both groups. Infections were uncommon following PICC and CICC insertion, with no significant difference in complication rates.
Sriskandarajah et al, 2015, [21]Retrospective single centerOncology patientsComparison of the incidence of thrombosis and infections in two groups who had either PICCs or long-term skin tunneled catheters (LTSTCs). In regards to infection, incidence rate was higher in the PICC group.
Rhee et al, 2015, [22]Retrospective observational studyNon-ICU patientsIn non-ICU patients with CLABSIs, underlying hematologic malignancy, neutropenia, and PICC lines were highly prevalent in this population.
Seckold et al, 2015, [23]Systematic review of prospective and retrospective studies in the English language referring to January 2000 until October 2013general population groups as well as oncology and non-oncology patientsBoth silicone and polyurethane PICC lines exhibit nearly identical overall average post-insertion compilation rates. Oncology patients experience higher levels of post-insertion complications.
Austin et al, 2015, [24]Single institution retrospective cohort reviewPatients in both critical care and burn settingsPICC line-associated complication rates are similar to those published in the critical care literature. Although higher than those published in the burn literature, they are similar to central venous catheter-associated complication rates. While PICC lines can be a useful resource in the treatment of burn patients, they are associated with significant and potentially fatal risks.
Coady et al, 2015, [25]Observational studyOncology patients with solid tumorsCentral venous ports and PICC lines in patients on chemotherapy had lower line infection rates than tunneled catheters.
Barsun et al, 2014, [26]Retrospective reviewBurn patientsSevere burn injury patients, long hospital admissions, and later hospital day of PICC insertions are at higher risk of developing PICC infections.
O’Brien et al, 2013, [27]Data collected for the period from May 2011 until January 2012Patients in a university center in CanadaInsertion of PICCs with minimum number of lumens reduces complications.
Chopra et al, 2013, [28]Meta-analysisAdult patientsNo differences in development of CLABSI in hospitalized patients with PICCs or CVCs. Consideration of risks and benefits before PICC use in inpatient settings is necessary.
Leroyer et al, 2013, [29]Prospective studyPatients with PICC under interventional radiologyHigher infection rate for PICCs compared to CVCs
Baxi et al, 2013, [30]Retrospective cohort studyUniversity of Michigan Health SystemHigh risk of CLABSI was related to immunosuppression, three PICC lumens and power-injectable PICC.
Armstrong et al, 2013, [31]Comparison between studied patients and a retrospective groupBurn patientsBacteremia rates were decreased in the burn patients who received antibiotic impregnated PICC lines.
Ugas et al, 2012, [32]ReviewCritically ill surgical patientsFor the period 1999 - 2011, there is a paucity of studies investigating the incidence of CVC- and PICC-related CLABSI in critically ill surgical populations.
Petree et al, 2012, [33]ReviewPatients eligible for PICC insertionSpecific strategies for skin decontamination, sterile barriers, needleless connectors and positive-pressure valves and proper securement with self-adhesive anchoring devices were more effective to reduce CLABSIs.
Al-Tawfig et al, 2012, [34]Prospective studyAll patients with PICCs hospitalized in a center in Saudi ArabiaAn overall BSI rate 4.5/1000 PICC-days was reported. The development of BSI was related to the underlying conditions and indications for the PICC line use.
Mollee et al, 2011, [35]Prospective, observational studyOncology patients in a single medical center in AustraliaThere is a need for standardized surveillance strategy in oncology adult patients, the use of PICC lines in such patients is supported, also the side of line insertion may influence risk of ClABSI.
Butler et al, 2011, [36]Retrospective reviewPatients in a large academic hospitalPrevious placement of a PICC may be related to catheter-associated infections in hemodialysis patients.
Gunst et al, 2011, [37]Non-randomized studySurgical ICU patientsPICCs were associated with fewer CLABSIs in long-stay surgical ICU patient compared to CVCs.
Fearonce et al, 2010, [38]ReviewBurn patients in a single centerPICC lines had a lower incidence rate for CLABSI compared to CVCs.
Al-Raiy et al, 2010, [39]Prospective studyPatients with CVCs in the ICUs and patients with PICCs hospital-wideThe median time for infection development was significantly longer in the patients with PICCs compared to CVCs.
Yap et al, 2006, [40]Study based on prospectively collected PICC complication dataOncology patients with solid tumorsComplication rate for year 2003 was lower compared to that of 2001 probably due to application of related strategies.
Griffiths et al, 2002, [41]Prospective studyComparison of patients with PICCs, CVCs, and peripheral venous access devicePICCs are considered a safe alternative.
Cowl et al, 2000, [42]Prospective studyPatients who received TPN via a PICC or CVCRegarding infections, the overall rate was similar for each catheter type.
Duerksen et al, 1999, [43]Study based on prospectively collected data compared over 3 different time periodsPatients who received parenteral nutritionRegarding infections, PICCs do not result in increased line-related sepsis.