Peripherally inserted central venous catheters (PICCs) in cancer patients placed by specialist nurses. A prospective observational study of 817 consecutive catheterizations

Abstract

Background: A central venous catheter (CVC) currently represent the most frequently adopted intravenous line for patients undergoing infusional chemotherqapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. Unfortunately, CVC insertion in subclavian or internal jugular vein represent a risk of pneumothorax, nerve puncture or major bleeding. The aim of this prospective observational study was explore the safety and efficacy of peripherally inserted central venous catheter (PICC) and to confirm its utility in clinical practice in cancer patients. Methods: Consecutive adult patients attending the oncology-hematology department hospital of Piacenzawere elegible if they had solid tumors or hematological malignances and required CVC insertion. Four types of possible complications were defined a priore: mechanical, thrombotic/hemorrhagic, Infection and malfunctioning. Operators included a group of four nurses (PICC-Team) with specific experience with ultrasound guided vein catheterization. All PICCs were inserted in a dedicate room, with US-guidance using an US-machine exclusively dedicated for PICC insertion (SONOSITE, NANO MAX, Milan). The catheter was inserted into the basilic or the brachial vein and the appropriate central position of the catheter tip was always verified either by the intracavitary electrocardiography during the procedure and by chest-X Ray at the end.