Yi et al 23examined predictive risk factors for thrombus formation in patients with PICCs using ultrasound. Zochios et al 22 concluded that larger, multi-lumen PICCs demonstrated a higher incidence of thrombosis due to turbulence and restricted blood flow. The number of lumens and the size of the catheter have been described as risk factors for thrombus formation 21. Anticoagulation can be initiated, preventing further complications. Not all occlusions lead to upper extremity venous thrombosis (UEVT), and thrombotic occlusions can be treated with antithrombotic agents, while UEVT is treated symptomatically or with catheter removal. The literature describes occlusion rates in PICCs and links them to the number of lumens selected, reporting occlusion rates ranging from 7% to 34%, with fibrin sheath formation being a common cause of mechanical occlusion 20. Depending on the clinical situation, preference should be given to single-lumen devices as outlined in clinical practice guidelines 16-19. These findings have prompted a greater focus on ensuring appropriate use of the PICC in hospitalised patients, including recommendations on the “appropriate choice of vascular access type 16-17“.ĭouble and triple-lumen PICCs (Figure 2) are associated with an increase in occlusion. Ī recent study, for example, found considerable variation in the use of the PICC, indications for use and associated complications in a sample of 10 hospitals 15. Please take a look at our videos for more information on PICC lines and their care.However, the choice of device may in some cases be due to the limited information defining the appropriate indications for use of the single-lumen (Figure 1) versus the multi-lumen PICC 14. The lines need to be flushed at regular intervals, and the dressing needs to be changed weekly by our team. Our team of skilled nurses teach and train patients the basics of sterile technique and how to properly care for the line. Infection is always a risk with intravenous access, but reported rates of PICC line infections are low if proper maintenance protocols are followed. PICC lines are thus a very versatile choice for patients requiring long-term venous access for conditions such as nutritional deficiencies or IV antibiotics. Additionally, some medications are caustic to the vasculature PICC lines allow these medications to be delivered to larger vessels that are less likely to be damaged. They can stay in the body for weeks or months, alleviating the need to subject your veins to the numerous needle sticks necessary if the PICC was not there. Sometimes these caps are blue as well.Ī PICC line is a safe, stable, and effective way to deliver IV medications. The one pictured has two lumens, which have orange “caps” to help keep the line sterile. Additionally, blood draws for lab purposes can also be extracted from the line. PICC lines can have 1-3 lumens, which allow medications to be attached and flow through the line. PICC lines are inserted by certified PICC specialists, who use ultrasound and X-ray images to ensure that the line is in the correct spot. “Catheter” is just another name for “tube” in the medical lexicon. I t is usually inserted in a smaller vein in the upper arm (peripheral), and terminates in a larger vein in the chest near the heart (central). PICC is an acronym for a Peripherally Inserted Central Catheter, and it is, in essence, a long IV line. This is one of the most common questions that patients have when they are told that they need home infusions.
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