PICCs venous catheters

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. 

Many different types of venous-access devices are available. Peripherally inserted central venous catheters (PICCs), which can be made of PU or silicone, are inserted into a vein in the arm rather than in the neck or chest. Nontunneled CVCs are shortterm catheters, made of PU or silicone as well, inserted into the internal jugular, subclavian, or femoral vein. Tunneled CVCs are long-term catheters implanted surgically under the skin. One end of the catheter remains outside the skin and the exit site is typically located in the chest. Passing the catheter under the skin helps to reduce the infection risk and provides stability. Implantable ports are similar to tunneled catheters but are left completely under the skin. They consist in small devices, made of plastic or titanium, inserted beneath the skin and connected to a catheter allowing vascular access. Under the skin, the port has a septum through which drugs can be injected and blood samples can be withdrawn. 

Central venous access device Non-tunelled CVC Tunelled CVC PICC Apheresis/ haemodialysis catheter Implantable Port Peripheral venous access device Cannula Midline catheter... 

Several factors influence the choice of a specific venous access device length and frequency of therapy patient comfort or activity ability to care for the device personal preference (physician, nurse, home health care and patient). Devices suitable for intermediate lengths of treatment (weeks to months) include PICCs, non-tunneled, and tunneled chest wall catheters. Longer therapies (months to years) favor tunneled external chest wall catheters and subcutaneous ports. Daily access would favor an external... 

Whereas subclavian vein (SCV) thrombosis can certainly occur with PICC insertion, the incidence should be reduced due to the smaller catheter sizes and lack of direct venous injury. It has been estimated that there is a 2% incidence of SCV thrombosis following PICC insertion. Grove and Pevec (2000) reported a 3.7% overall thrombosis rate in patients with PICC, finding... 

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