Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study

• Published in: Supportive care in cancer 2015-02, Vol.23 (2), p.403-409
• Main Authors: Cotogni, Paolo, Barbero, Cristina, Garrino, Cristina, Degiorgis, Claudia, Mussa, Baudolino, De Francesco, Antonella, Pittiruti, Mauro
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cancer; Cancer research; Catheter-Related Infections - epidemiology; Catheter-Related Infections - etiology; Catheterization; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Catheterization, Peripheral - statistics & numerical data; Catheters; Central Venous Catheters - adverse effects; Drug Therapy - methods; Female; Follow-Up Studies; Health aspects; Home Care Services, Hospital-Based - statistics & numerical data; Hospitalization; Humans; Incidence; Italy; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - drug therapy; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Parenteral Nutrition, Home - methods; Parenteral Nutrition, Home - statistics & numerical data; Prospective Studies; Rehabilitation Medicine; Reproducibility of Results; Thrombosis - epidemiology; Thrombosis - etiology
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-014-2387-9

Purpose Few prospective follow-up studies evaluating the use of peripherally inserted central catheters (PICCs) to deliver chemotherapy and/or home parenteral nutrition (HPN) have focused exclusively on oncology outpatients. The aim of this prospective study was to assess the reliability and the safety of PICCs over a 5-year use in non-hospitalized cancer patients requiring long-term intravenous therapies. Methods Since June 2008, all adult oncology outpatient candidates for PICC insertion were consecutively enrolled and the incidence of catheter-related complications was investigated. The follow-up continued until the PICC removal. Results Two hundred sixty-nine PICCs in 250 patients (98 % with solid malignancies) were studied, for a total of 55,293 catheter days (median dwell time 184 days, range 15–1,384). All patients received HPN and 71 % received chemotherapy during the study period. The incidence of catheter-related bloodstream infections (CRBSIs) was low (0.05 per 1,000 catheter days), PICC-related symptomatic thrombosis was rare (1.1 %; 0.05 per 1,000 catheter days), and mechanical complications were uncommon (13.1 %; 0.63 per 1,000 catheter days). The overall complication rate was 17.5 % (0.85 per 1,000 catheter days) and PICCs were removed because of complications only in 7 % of cases. The main findings of this study were that, if accurately managed, PICCs can be safely used in cancer patients receiving chemotherapy and/or HPN, recording a low incidence of CRBSI, thrombosis, and mechanical complications; a long catheter life span; and a low probability of catheter removal because of complications. Conclusions Our study suggests that PICCs can be successfully utilized as safe and long-lasting venous access devices in non-hospitalized cancer patients.