TY - JOUR
T1 - Complication rates among peripherally inserted central venous catheters and centrally inserted central catheters in the medical intensive care unit
AU - Nolan, Matthew E.
AU - Yadav, Hemang
AU - Cawcutt, Kelly A.
AU - Cartin-Ceba, Rodrigo
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - 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.
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.
KW - Adverse event
KW - Catheter-associated infection
KW - Central venous catheter thrombosis
KW - Central venous catheterization
KW - Deep vein thrombosis
KW - Peripherally inserted central catheter
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U2 - 10.1016/j.jcrc.2015.09.024
DO - 10.1016/j.jcrc.2015.09.024
M3 - Article
C2 - 26519981
AN - SCOPUS:84951320612
SN - 0883-9441
VL - 31
SP - 238
EP - 242
JO - Journal of Critical Care
JF - Journal of Critical Care
IS - 1
ER -