title: Peripherally inserted central catheters in an acute-care hospital.
abstract: BACKGROUND
  Peripherally inserted central catheterization is a relatively new approach for intravenous therapy in acute-care hospitals. Few studies are available on peripherally inserted central catheters (PICCs) used in adult patients in an acute-care setting. We examine the natural history and outcome of PICC use in our hospital.
  
  
  METHODS
  A retrospective review was undertaken of all hospitalized patients who had PICCs inserted in an acute-care, metropolitan teaching hospital for any reason from July 1991 through July 1992. Patients who had PICCs inserted, used, and then removed in the same hospitalization were evaluated.
  
  
  RESULTS
  A total of 135 PICCs were inserted in 114 patients. Six PICCs (4.4%) were inserted in intensive care unit settings and 129 (95.6%) in general medical or surgical service. The mean duration catheters were in place before removal was 14.1 days. Sixty-three catheters (46.7%) were removed following completion of therapy. The rate of PICC-related infection was 2.2% (three catheters). The occlusion rate was higher for 20-gauge catheters (18.4%) than for 18-gauge catheters (8.2%) (P = .08). When the rate of complications was compared as a function of catheter use (total parenteral nutrition vs any other use), there was no statistically significant difference (P = .12). Overall complications related to catheter insertion and removal were uncommon.
  
  
  CONCLUSIONS
  Based on our study, we conclude that the PICC provides a reasonable and safe alternative to other centrally placed venous devices. In addition, the convenience of maintaining a PICC compared with peripheral intravenous access makes this an attractive method for in-hospital use.
authors.affiliation: Department of Medicine, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY.
authors.forename: S
authors.initials: S
authors.lastname: Lam
authors.forename: R
authors.initials: R
authors.lastname: Scannell
authors.forename: D
authors.initials: D
authors.lastname: Roessler
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D012189:Retrospective Studies