Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit

Matthew E. Nolan, Hemang Yadav, Kelly A. Cawcutt, Rodrigo Cartin-Ceba

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

PURPOSE: There are limited contemporary data describing the rates of catheter-related deep vein thrombosis (CRDVT) and central line-associated bloodstream infection for peripherally inserted central venous catheters (PICCs) and centrally inserted central venous catheters (CICCs) in the medical intensive care unit (ICU).

METHODS: We performed a retrospective cohort study of 200 PICCs (dual/triple lumen) and 200 CICCs (triple/quadruple lumen) placed in medical ICU adults at Mayo Rochester between 2012 and 2013. Central lines were followed from insertion time until hospital dismissal (primary analysis) or ICU discharge (secondary analysis). Symptomatic CRDVT was determined by Doppler ultrasound. Central line-associated bloodstream infection was defined according to federal reporting criteria.

RESULTS: During 1730 PICC days and 637 CICC days, the incidence of CRDVT when followed until hospital dismissal was 4% and 1% (4.6 and 3.1 per 1000 catheter-days), respectively, P = .055. When censored at the time of ICU dismissal, the rates were 2% and 1% (5.3 and 3.7 per 1000 catheter-days), P = .685. Only 1 central line-associated bloodstream infection occurred in a PICC following ICU dismissal, P > .999.

CONCLUSIONS: Thrombotic and infectious complications were uncommon following PICC and CICC insertion, with no significant difference in complication rates observed. Half of PICC DVTs occurred on the general floor, and like all central catheters placed in the ICU, PICCs should be aggressively discontinued when no longer absolutely needed.

Original languageEnglish (US)
Pages (from-to)238-242
Number of pages5
JournalJournal of Critical Care
Volume31
Issue number1
DOIs
StatePublished - Feb 1 2016

Fingerprint

Central Venous Catheters
Intensive Care Units
Catheters
Venous Thrombosis
Infection
Doppler Ultrasonography
Primary Health Care
Cohort Studies
Retrospective Studies

Keywords

  • Adverse event
  • Catheter-associated infection
  • Central venous catheter thrombosis
  • Central venous catheterization
  • Deep vein thrombosis
  • Peripherally inserted central catheter

ASJC Scopus subject areas

  • Medicine(all)
  • Critical Care and Intensive Care Medicine

Cite this

Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit. / Nolan, Matthew E.; Yadav, Hemang; Cawcutt, Kelly A.; Cartin-Ceba, Rodrigo.

In: Journal of Critical Care, Vol. 31, No. 1, 01.02.2016, p. 238-242.

Research output: Contribution to journalArticle

Nolan, Matthew E. ; Yadav, Hemang ; Cawcutt, Kelly A. ; Cartin-Ceba, Rodrigo. / Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit. In: Journal of Critical Care. 2016 ; Vol. 31, No. 1. pp. 238-242.
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AB - PURPOSE: There are limited contemporary data describing the rates of catheter-related deep vein thrombosis (CRDVT) and central line-associated bloodstream infection for peripherally inserted central venous catheters (PICCs) and centrally inserted central venous catheters (CICCs) in the medical intensive care unit (ICU).METHODS: We performed a retrospective cohort study of 200 PICCs (dual/triple lumen) and 200 CICCs (triple/quadruple lumen) placed in medical ICU adults at Mayo Rochester between 2012 and 2013. Central lines were followed from insertion time until hospital dismissal (primary analysis) or ICU discharge (secondary analysis). Symptomatic CRDVT was determined by Doppler ultrasound. Central line-associated bloodstream infection was defined according to federal reporting criteria.RESULTS: During 1730 PICC days and 637 CICC days, the incidence of CRDVT when followed until hospital dismissal was 4% and 1% (4.6 and 3.1 per 1000 catheter-days), respectively, P = .055. When censored at the time of ICU dismissal, the rates were 2% and 1% (5.3 and 3.7 per 1000 catheter-days), P = .685. Only 1 central line-associated bloodstream infection occurred in a PICC following ICU dismissal, P > .999.CONCLUSIONS: Thrombotic and infectious complications were uncommon following PICC and CICC insertion, with no significant difference in complication rates observed. Half of PICC DVTs occurred on the general floor, and like all central catheters placed in the ICU, PICCs should be aggressively discontinued when no longer absolutely needed.

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