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A Randomized Trial of Complications of Peripherally and Centrally Inserted Central Lines in the Neuro-Intensive Care Unit: Results of the NSPVC Trial

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An Invited Editorial Commentary to this article was published on 27 September 2019

Abstract

Objective

The objective of this study was to compare the relative number of complications from peripherally inserted central venous catheters (PICC) and centrally inserted central venous catheters (CVC) in the neuroscience intensive care unit (NSICU).

Methods

This study was carried out in a 32-bed NSICU in a large academic hospital in the USA from July 2015 until January 2017. Patients admitted requiring central venous access were randomly assigned to have a PICC or CVC inserted. Complications were recorded and compared. The primary outcome was all complications as well as combined numbers of large vein thrombosis, central-line-associated blood stream infections, and insertional trauma. Outcomes were compared using the Fisher’s exact test, logistic regression, or unpaired T tests, as appropriate.

Results

One hundred and fifty-two patients were enrolled; 72 were randomized to the PICC arm and 80 to the CVC arm. There were no crossovers, withdrawals, nor losses to follow-up. The study was stopped at the second pre-planned interim analysis for futility. The combined number of large vein thrombosis, central-line-associated blood stream infection, and insertional trauma was 4/72 in the PICC arm and 1/80 in the CVC group (OR 4.6 (95% CI 0.5–42.6) p = 0.14). The number of all complications in the PICC arm was 14/72 compared to 10/80 in the CVC arm (OR 1.7 (95% CI 0.7–4.1) p = 0.24).

Conclusions

PICCs and CVCs have similar numbers of complications when placed in patients admitted to the NSICU.

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Funding

Database software was funded by NIH/NCRR Grant Number UL1RR033184, the remainder of the study was departmentally/institutionally funded.

Author information

Authors and Affiliations

  1. Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA

    Nicholas J. Brandmeir

  2. Department of Neuroscience, West Virginia University, Morgantown, WV, USA

    Nicholas J. Brandmeir

  3. Department of Neurosurgery, West Virginia University, Suite 4300, 1 Medical Center Drive, Morgantown, WV, USA

    Nicholas J. Brandmeir

  4. Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

    Justin R. Davanzo, Russell Payne, Sprague W. Hazard & J. Christopher Zacko

  5. Department of Neurosurgery, University of Louisville, Louisville, KY, USA

    Emily P. Sieg

  6. Penn State University College of Medicine, Hershey, PA, USA

    Ashiya Hamirani, Annie Tsay & Jeffrey Watkins

  7. Department of Anesthesia and Perioperative Services, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

    Sprague W. Hazard

Authors
  1. Nicholas J. Brandmeir
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  2. Justin R. Davanzo
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  3. Russell Payne
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  4. Emily P. Sieg
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  5. Ashiya Hamirani
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  6. Annie Tsay
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  7. Jeffrey Watkins
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  8. Sprague W. Hazard
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  9. J. Christopher Zacko
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Contributions

NJB was involved in Protocol/Project Development, Data collection/management, Data analysis, Manuscript writing; JRD contributed to Project Development, data collection/management, manuscript editing; RP took part in Data collection, data analysis, manuscript editing; EPS was involved in Data collection, data analysis, manuscript editing; AH was involved in Data collection/management; AT was involved in Data collection/management; JW was involved in Data collection/management; SWH was involved in Data collection/management, protocol/project development, data analysis, manuscript editing/writing; JCZ was involved in Protocol/project development, data analysis, manuscript editing, project supervisor/Primary investigator.

Corresponding author

Correspondence to Nicholas J. Brandmeir.

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Conflict of interest

The authors declare that they have no conflict of interest to disclose.

Ethical approval/informed consent

This study was carried out with the approval of the institutional review board and in accordance with the 1964 Declaration of Helsinki. Informed consent was obtained for all participants in the research.

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This study was carried out in accordance with the CONSORT standards and a checklist is provided.

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Brandmeir, N.J., Davanzo, J.R., Payne, R. et al. A Randomized Trial of Complications of Peripherally and Centrally Inserted Central Lines in the Neuro-Intensive Care Unit: Results of the NSPVC Trial. Neurocrit Care 32, 400–406 (2020). https://doi.org/10.1007/s12028-019-00843-z

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  • DOI: https://doi.org/10.1007/s12028-019-00843-z

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