Peripherally Inserted Central Catheter Postinsertion Complications: A Retrospective Study

Abstract

Background: Peripherally inserted central catheters (PICCs) are increasing in popularity with over 4.3 million insertions globally each year. However, there remains little quality evidence as to the safest catheter to insert with the lowest levels of postinsertion complications. Methods: Retrospective chart audit comprising adult patients having either a silicone or polyurethane PICC inserted by specialist nurses in the Medical Imaging Department over a predetermined time frame. Data extracted from the charts included demographic data, patient status, reason for insertion, and reason for removal of a PICC. Results: A total of 295 PICC insertions were included in the study. Of these, 141 were silicone PICCs and 154 were polyurethane PICCs. The sample comprised various patient groups including 142 inpatients, 80 outpatients, and 73 transitional. As to reasons for requiring a PICC, 102 patients were oncology patients, 164 patients required intravenous antibiotics, and 29 patients required other types of medications. Reasons for removal of catheter varied from no complication/completion of therapy (67.8%) to infection (11.2%), migration (5.8%), deceased (4.7%), occlusion (3.7%), thrombus (2.7%), breakage (2.7%), phlebitis (0.3%), and upgrade to triple lumen catheter (0.3%). Conclusions: PICCs remain safe and reliable; the greatest predictors of postinsertion complications were number of lumens and oncology patient groups. The emerging trend of health services to transition inpatients to outpatients in the community with catheters in situ was shown to be a safe practice.