Peripherally inserted central catheter

HPI KS is a 25-year-old woman with ALL who presents to the oncology clinic complaining that she has had fevers and chills for the past day. KM receives chemotherapy via a peripherally inserted central catheter (PICC) inserted in her left antecubital vein, last dose 3 weeks ago. 

MoAb monoclonal antibody PICC peripherally inserted central catheter... 

Example 9.4 In a parenteral antibiotic study, blood levels are required to be greater than 20 pm/mL. A new device was developed to monitor blood levels and, in cases where levels were less than 15 pm/mL, for more than 4-5 min, the device spiked the dosage to bring it to 20-30 pm/mL, through a peripherally inserted central catheter. The validation on a nonhuman simulation study produced the resultant data (Table 9.29). 

Solutions containing 12.5 % dextrose and higher cannot be given peripherally and require a central line (peripherally inserted central catheter or PICC, port or central access). 

Catheter device selection is based on a number of factors, including the plarmed application and placement site, duration of implantation, composition of fluids infused, and frequency of access (Namyslowski and Patel, 1999). Vascular catheters can be divided into two genei groups shortterm, temporary catheters that are placed percutaneously, and long-term, indwelling vascular catheters that usually require a surgical insertion. Temporary catheters include short peripheral venous and arterial catheters, nontunneled central venous and arterial catheters, and peripherally inserted central catheters (Pearson, 1996). Tunneled central venous catheters and totally implantable intra-... 

Respiratory Chylous pleural effusions have been reported in two adults who received parenteral nutrition delivered via peripherally inserted central catheters [19 ]. 

Johnson TJ, Jamous EG, Kooistra A, Zawada ET. Iatrogenic chylothorax due to pleural cavity extravasation of total parenteral nutrition in two adults receiving nutrition through a peripherally inserted central catheter. Hosp Pract (Minneap) 2010 38 (1) 50-2. 

MidUne catheters and peripherally inserted central catheters (PlCC) are inserted in a peripheral vein but the tip rests in a larger vein. The infusion fluid flows directly in the larger vein which diminishes the chance of phlebitis. Both types of catheters are typically inserted in a vein in the upper arm. The midline catheter ends at armpit height the tip of the PICC rests in the vena cava superior. The PlCC may have single or multiple lumens. The PlCC line can be used as a central venous catheter for infusion which needs fast dilution or distribution or both such as antibiotics, pain medicine, chemotherapy, nutrition, etc. 

Long-term central venous access devices used for chemotherapy can be categorized into peripherally inserted central catheters (PlCCs), chest wall external catheters (tunneled and non-tunneled), and subcutaneous ports (chest wall and extremity). 

Fig. 6.4. Transverse ultrasound image of a needle tip within a basilic vein during a peripherally inserted central catheter insertion under ultrasound guidance...

Cardella JF, Fox PS, Lawler JB (1993) Interventional radiologic placement of peripherally inserted central catheters. J Vase Interv Radiol 4 653-660... 

Cardella JF, Cardella K, Bacci N, Fox PS, Post JH (1996) Cumulative experience with 1,273 peripherally inserted central catheters at a single institution. J Vase Interv Radiol 7 5-13... 

Chrisman HB, RA Omary, Nemcek AA, Ryu RK, Saker MB, Vogelzang RL (1999) Peripherally inserted central catheters guidance with use of US versus venography in 2,650 patients. J Vase Interv Radiol 10 473-475... 

Chopra V, O Horo JC, Rogers MA, et al. The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults a systematic review and meta-analysis. Infect Control Hosp Epidemiol September 2013 34(9) 908-18. 

Observational studies The effect of peripherally inserted and non-peripherally inserted catheters on infection rates in adults requiring home parenteral nutrition (PN) has been examined in a retrospective study of 101 patients. Seventy-five percent of infections developed within the first 6 months of hospital discharge, and most of these were attributed to gram positive organisms. Patients with peripherally inserted catheters had a significantly higher rates of infections compared with non-peripherally inserted catheters (P=0.018) [lOl ]. A four-year review of 145 cases of peripherally inserted central catheters for long-term PN in infants with intestinal failure showed that the overall... 

Piper HG, de Silva NT, Amaral JG, Avitzur Y, Wales PW. Peripherally inserted central catheters for long-term parenteral nutrition in infents with intestinal failure. J Pediatr Gastroenterol Nutr May 2013 56(5) 578-81. 

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