Original

Intensive Care Medicine

, Volume 37, Issue 2, pp 284-289

First online:

Peripherally inserted central venous catheters and central venous catheters related thrombosis in post-critical patients

  • Manuela BonizzoliAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital
  • , Stefano BatacchiAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital
  • , Giovanni CianchiAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital
  • , Giovanni ZagliAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital Email author 
  • , Francesco LapiAffiliated withDepartment of Preclinical and Clinical Pharmacology, University of FlorenceEpidemiology Unit, Regional Agency for Health Care Services of Tuscany
  • , Valentina TucciAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital
  • , Giacomo MartiniAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital
  • , Simona Di ValvasoneAffiliated withPostgraduate School of Anesthesia and Intensive Care, Faculty of Medicine, University of Florence
  • , Adriano PerisAffiliated withAnesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital

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Abstract

Background

Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU).

Methods

Data of patients admitted to the ICU (Careggi Teaching Hospital, Florence, Italy; January–August 2008) and discharged with a central venous device were sequentially studied. During the first 4 months, CVCs were used (CVC group), whereas during the last 4 months, PICCs were used (PICC group). Demographic/clinical and catheter-related data were collected. Intensivists performed Doppler examination at ICU discharge and 7, 15, and 30 days after placement.

Results

Data of 239 patients were analyzed (125 of CVC group, 114 of PICC group). A total of 2,747 CVC-days and 4,024 PICC-days of observation were included. Patient characteristics were comparable between groups. Patients with PICC had a significantly higher incidence rate of deep venous thrombosis (DVT) than patients with CVC (27.2 vs. 9.6%, P = 0.0012). The rate of DVT/1,000 catheter days was 4.4 for CVCs and 7.7 for PICCs. Eighty percent of DVTs occurred within 2 weeks after insertion. Binary logistic analysis showed a two-fold increased risk for women and a three-fold increased risk when using the left basilic vein in the PICC group.

Conclusions

In our post-critically ill population, PICCs were associated with a higher rate of DVT complications than CVCs. Routine ultrasound surveillance for the first 2 weeks after patient discharge from the ICU with a PICC and preferential use of CVC for these patients may be warranted.

Keywords

Peripherally inserted central venous catheters Central venous catheters Critically ill patients Deep venous thrombosis Post-intensive ward