A team-based multidisciplinary approach to managing peripherally inserted central catheter complications in high-risk haematological patients: a prospective study

• Published in: Supportive care in cancer Vol. 24; no. 1; pp. 93 - 101
• Main Authors: Curto-García, Natalia, García-Suárez, Julio, Callejas Chavarria, Marta, Gil Fernández, Juan José, Martín Guerrero, Yolanda, Magro Mazo, Elena, Marcellini Antonio, Shelly, Juárez, Luis Miguel, Gutierrez, Isabel, Arranz, Juan José, Montalvo, Irene, Elvira, Carmen, Domínguez, Pilar, Díaz, María Teresa, Burgaleta, Carmen
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2016; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Blood diseases; Cancer; Catheter-Related Infections - etiology; Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Catheters; Chemotherapy; Female; Hematologic Diseases - etiology; Hematology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Prospective Studies; Rehabilitation Medicine; Risk Factors; Thrombosis - etiology; Young Adult; PICC-related thrombosis; PICC-related bloodstream infection; Haematological malignancies; Peripherally inserted central catheters
• DOI: 10.1007/s00520-015-2754-1
• EISSN: 1433-7339
• ISSN: 0941-4355

Purpose
Use of peripherally inserted central catheters (PICCs) has markedly increased during the last decade. However, there are few studies on use of PICCs in patients with haematological malignancies (HM) receiving intensive chemotherapy. Preliminary data suggest a higher rate of PICC-related complications in these high-risk patients. This prospective observational single-centre study aimed to investigate PICC-related complications after implementation of a multidisciplinary approach to PICC care and compared it with previous literature.
Methods
A total of 44 PICCs were inserted in 36 patients (27.3 %, thrombocytopenia <50 × 10
9
/L at insertion) over 5045 PICC days (median duration, 114.5 days).
Results
No major insertion-related complications were observed. Major late complications were obstruction in 13.6 % (1.19/1000 PICC days) of patients, catheter-related bloodstream infection in 6.8 % (0.59/1000 PICC days), and catheter-related thrombosis in 4.5 % (0.39/1000 PICC days). Premature PICC removal occurred in 34 % (2.97/1000 PICC days) of patients. The overall rate of potentially major dangerous complications was particularly low (11.36 %, 0.99/1000 PICC days) compared with previous studies.
Conclusions
This study highlights the utility of a multidisciplinary approach for PICC care in adults with HM receiving intensive chemotherapy. We provide further data to support use of PICCs in such patient populations.