Author: Appleton N.D.; Corris A.; Edwards C.; Kenyon A.; Walsh C.J.
Abstract: Aim: Review the outcomes of a dedicated PICC service. Method: Retrospective review of a prospectively maintained database. Catheter related blood stream infection (CRBSI) was defined as positive paired qualitative blood cultures from a peripheral vein and PICC.
Results: Between January 2010 and January 2012, 225 patients (115 male, 110 female) had 294 single lumen lines inserted. Median age was 69 years old (range 22-98). 43 had >1 sited and of these, 19 had synchronous lines. Indications for insertion: reliable peripheral access (149, 51%), parenteral nutrition (PN) (145, 49%) of which, fifty (34%) were for type II intestinal failure (i.e. >28 days). 283 (96.3%) were placed under ultrasound guidance. Total line days was 8063 (median 16 days, range 0-368).
Complications: phlebitis (4, 1.4% or 0.5/1000 catheter days) and occlusion (16, 5.4% or 2.0/ 1000 catheter days). Line associated infection was suspected clinically in 14 patients (4.8% or 1.7/1000 catheter days), however only one had confirmed CRBSI (0.3% or 0.1/1000 catheter days). Conclusion: Current published CRBSI are 2.1-2.2/1000 catheter days. With a dedicated team, CRBSIs are kept to a bare minimum. Furthermore, synchronous lines can be successfully used which includes use in the management of complex patients with type II intestinal failure.
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