Volume 38, Issue 2 , Pages 149-153, March 2010
Peripherally inserted central venous catheters in the acute care setting: A safe alternative to high-risk short-term central venous catheters
Background
Peripherally inserted central venous catheters (PICCs) serve as an alternative to short-term central venous catheters (CVCs) for providing intravenous (IV) access in the hospital. It is not clear which device has a lower risk of central line–associated bloodstream infection (CLABSI). We compared CVC- and PICC-related CLABSI rates in the setting of an intervention to remove high-risk CVCs.
Methods
We prospectively followed patients with CVCs in the non–intensive care units (ICUs) and those with PICCs hospital-wide. A team evaluated the need for the CVC and the risk of infection, recommended the discontinuation of unnecessary or high-risk CVCs, and suggested PICC insertion for patients requiring prolonged access. Data on age, gender, type of catheter, duration of catheter utilization, and the development of CLABSIs were obtained.
Results
A total of 638 CVCs were placed for 4917 catheter-days, during which 12 patients had a CLABSI, for a rate of 2.4 per 1000 catheter-days. A total of 622 PICCs were placed for 5703 catheter-days, during which 13 patients had a CLABSI, for a rate of 2.3 per 1000 catheter-days. The median time to development of infection was significantly longer in the patients with a PICC (23 vs 13 days; P
=
.03).
Conclusion
In the presence of active surveillance and intervention to remove unnecessary or high-risk CVCs, CVCs and PICCs had similar rates of CLABSIs. Given their longer time to the development of infection, PICCs may be a safe alternative for prolonged inpatient IV access.
Key Words: Peripherally inserted central catheters, central venous catheters, central line associated blood stream infection, risk
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Conflicts of interest: None to report.
PII: S0196-6553(09)00745-7
doi:10.1016/j.ajic.2009.06.008
© 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc All rights reserved.
Volume 38, Issue 2 , Pages 149-153, March 2010
