The Use of Peripherally Inserted Central Catheters in Intensive Care: Should you Pick the PICC?

Abstract

Peripherally inserted central catheters (PICCs) are useful routes for intermediate central venous access; however, there is a paucity of data regarding their use in the intensive care setting. We have been using PICCs on our ICU since 2006 and have undertaken a retrospective audit of all PICC use during one year to define complication rates. PICCs were inserted by a dedicated vascular access team (VAT). Microbiology and radiology databases were used to assess rates of line-related bacteraemias and catheter misplacements. Blockage rates were collected from VAT records. Data was available on 116 PICCs, corresponding to 1,558 line days. The median duration of placement of PICCs was 9 days (range 0–100) in situ with a misplacement rate at insertion of 12.1%. The catheter-related blood stream infection rate was zero. The blockage rate was 29.5/1,000 line days; 87% of these blockages were cleared using urokinase. We believe that PICCs can be safely used in intensive care patients.