peripherally-inserted central catheter (PICC)

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Introduction

Implanted right atrial catheter

Classification

Indications

Contraindications

Procedure

Use of catheter.[2]

* Volume in PICC about 2 mL.

# heparin used for flush in other types of catheter(s)

Complications

* more common with PICCs than with other central venous catheters[3]; 10 fold increased risk[3]

Management

  • for use up to 1 year[1]
  • single lumen PICC line safest[7]

More general terms

More specific terms

Additional terms

References

  1. 1.0 1.1 1.2 1.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2013, 2015, 2018.
  2. 2.0 2.1 WLA VAMC PICC line nursing
  3. 3.0 3.1 3.2 3.3 3.4 Journal Watch. June 6, 2013 Massachusetts Medical Society http://www.jwatch.org
    Chopra V et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: A systematic review and meta-analysis. Lancet 2013 May 20 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23697825
  4. 4.0 4.1 Chopra V et al The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method. Ann Intern Med. 2015;163(6_Supplement):S1-S40. Sept 15, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26369828 <Internet> http://annals.org/article.aspx?articleid=2436759
  5. Greene MT et al. The association between PICC use and venous thromboembolism in upper and lower extremities. Am J Med 2015 Sep; 128:986 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25940453
  6. 6.0 6.1 American Academy of Pediatrics - Committee on Infectious Diseases and the Pediatric Infectious Diseases Society. Choosing Wisely. November 12, 2018 http://www.choosingwisely.org/societies/american-academy-of-pediatrics-committee-on-infectious-diseases-and-the-pediatric-infectious-diseases-society/
  7. 7.0 7.1 Bozaan D, Skicki D, Brancaccio A et al. Less lumens-less risk: A pilot intervention to increase the use of single-lumen peripherally inserted central catheters. J Hosp Med 2019 Jan 8; 14:42 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30379146 https://www.journalofhospitalmedicine.com/jhospmed/article/177747/hospital-medicine/less-lumens-less-risk-pilot-intervention-increase-use
  8. 8.0 8.1 McGill RL, Ruthazer R, Meyer KB, Miskulin DC, Weiner DE. Peripherally Inserted Central Catheters and Hemodialysis Outcomes. Clin J Am Soc Nephrol. 2016 Aug 8;11(8):1434-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27340280 Free PMC Article
  9. 9.0 9.1 Paje D, Rogers MAM, Conlon A et al. Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: A prospective cohort study. Ann Intern Med 2019 Jun 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31158846 https://annals.org/aim/article-abstract/2735181/use-peripherally-inserted-central-catheters-patients-advanced-chronic-kidney-disease?doi=10.7326%2fM18-2937
  10. 10.0 10.1 Swaminathan L, Flanders S, Horowitz J et al. Safety and outcomes of midline catheters vs peripherally inserted central catheters for patients with short-term indications: A multicenter study. JAMA Intern Med 2022 Jan; 182:50-58. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34842905 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2786212
  11. 11.0 11.1 11.2 Mitbander UB et al. Patterns of use and outcomes of peripherally inserted central catheters in hospitalized patients with solid tumors: A multicenter study. Cancer 2022 Oct; 128:3681 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35943390 https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.34410
  12. 12.0 12.1 Bredenberg E et al. Promoting appropriate midline catheter and PICC placement through implementation of an EHR-based clinical decision support tool: An interrupted time-series analysis. J Hosp Med 2023 Jun; 18:483. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37052429 https://shmpublications.onlinelibrary.wiley.com/doi/10.1002/jhm.13093