Peripherally Inserted Central Catheter and Complications

A peripherally inserted central catheter (PICC) is one of the methods to provide intravenous access for a long period of time. Although PICC is considered to be one of the safest and most advanced ways to provide access to the central venous system for more than two weeks, the implementation may result in complications for infants. Westergaard, Classen, and Walther-Larsen (2013) analyzed the risk factors and safety of several intravenous devices such as PIC, CVC, PICC, and TCVC in their article “Peripherally inserted central catheters in infants and children – indications, techniques, complications and clinical recommendations”. Findings showed that PICC is the most appropriate for children due to the low risk of complications. Another research was conducted by Bowers, Speroni, Jones, and Atherton in 2008. The authors evaluated the connection between the type of device and occlusion rates. PICCs and central vascular access devices (CVADs) were investigated from this perspective. Researchers had found out that PICCs were more efficient in comparison to CVADs. Also, Bowers et al. (2008) came to the conclusion that expenses for PICCs might be reduced with the usage of heparinized saline flushing.

Although PICC is the safest method to have access to the venous system, side effects such as occlusions or infections may occur. Panagiotounakou et al. (2014) examined the connection between the complications and the insertion site in premature newborns in their article “Peripherally inserted central venous catheters: Frequency of complications in premature newborn depends on the insertion site”. The insertion into the axillary vein turned out to be the most effective as far as it reduced the risk of complications and, consequently, morbidity and mortality rates of neonates. The misplacement of PICC is one more possible complication. Invasive methods are very harmful to the health of neonates. Catudal and Sharpe (2011) described a case study of an infant patient with a misplaced PICC. Non-invasive methods such as movement of patient’s arm, regulation of the angle of bend, neck extension, and arms deductions were utilized by doctors. The authors illustrated the successful results of non-invasive interventions.

As has been already mentioned, blood infections comprise another possible side-effect of PICCs implementation. According to Butler, Sood, Mojibian, and Tal (2011), the risk to receive infection was higher for people who suffer from kidney diseases. Researchers found out that people with hemodialysis were at a higher risk to receive catheter-related infections in comparison to other individuals.

The role of proper management and adequate knowledge may be crucial for the elimination of risks during catheter insertion. Petree, Wright, Sanders, and Killion (2012) evaluated the most effective ways to reduce the risk of infections in the article “Reducing blood stream infections during catheter insertion”. Findings demonstrated that a variety of devices for better safety, sterilization and needless methods of insertion decreased the possibility of the blood infection. The importance of the proper safety measures was emphasized by Rumsey and Richardson (1995) in their article “Management of infection and occlusion associated with vascular access devices”. Apart from the importance of safety measures, authors dwelled on the significance of the technique of positive pressure flush for the prevention of occlusions. Finally, Ngo and Murphy (2005) examined the role of nurses’ knowledge in reducing adverse outcomes of PICCs. Thus, the improvement of nurses’ competence and skills was proved to be valuable for the elimination of complications and risks.

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