The Effect of Peripherally Inserted Central Catheter (PICC) Valve Technology on Catheter Occlusion Rates - The ‘ELeCTRiC’ Study

• Published in: The journal of vascular access 2012-10, Vol.13 (4), p.421-425
• Main Authors: Johnston, Andrew J., Streater, Carmel T., Noorani, Remy, Crofts, Joanne L., Del Mundo, Aldwin B., Parker, Richard A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Catheter Obstruction - etiology; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - instrumentation; Central Venous Catheters; Early Termination of Clinical Trials; England; Equipment Design; Female; Fibrinolytic Agents - therapeutic use; Humans; Intensive Care Units; Male; Middle Aged; Risk Factors; Thrombolytic Therapy - methods; Treatment Outcome; Upper Extremity Deep Vein Thrombosis - diagnosis; Upper Extremity Deep Vein Thrombosis - drug therapy; Upper Extremity Deep Vein Thrombosis - etiology; Urokinase-Type Plasminogen Activator - therapeutic use
• ISSN: 1129-7298; 1724-6032
• DOI: 10.5301/jva.5000071

Purpose Peripherally Inserted Central Catheters (PICCs) are increasingly being used to provide short to medium-term central venous access. The current study was designed to test the hypothesis that PICC valve technology does not influence PICC occlusion rates. Methods Intensive care unit (ICU) patients who required a PICC were randomized to one of three types of dual lumen PICC (open ended non-valved, Groshong valve, PASV valve). PICC occlusions were recorded and managed with a protocol that used urokinase. Results A total of 102 patients were recruited to the study. The overall risk of occlusion per catheter was 35% (95% CI 26% to 44%). The overall rate of occlusion was 76 occlusions per 1000 catheter days (95% CI 61 to 95). Presence or type of valve did not significantly influence this rate (open-ended non-valved PICC 38% of catheters, 79 occlusions per 1000 catheter days; Groshong 38% of catheters, 60 occlusions per 1000 catheter days; PASV 27% of catheters, 99 occlusions per 1000 catheter days). The dose of urokinase required to treat PICC occlusions did not significantly differ between PICC types. Conclusions Valved PICCs do not appear to influence PICC occlusion rates.