Peripherally inserted central venous catheters for autologous blood progenitor cell transplantation in patients with haematological malignancies.
BACKGROUND
In contrast to the high risk of haemorrhage associated with the implantation of a central venous catheter (CVC) via the internal jugular or subclavian access, the use of a peripherally inserted catheter (PICC) offers the advantage of a lower risk of bleeding complications. However, the rate of phlebitis is higher with the PICC and its use has been declining. We have studied the benefits and adverse events of a new type of PICC and a common type.


METHODS
From October 1999 to October 2001, 70 PICCs (Olimpicc, Vygon, Germany, n=40; and LIFECATH-PICC(PUR)5FR Vygon, Germany, n=30) were inserted into 66 patients with haematological malignancies and used for high-dose chemotherapy, total parenteral nutrition and autologous blood stem cell transplantation. While removing the catheter, central and peripheral blood cultures were taken. The catheter tip was investigated by the semi-quantitative roll-out method of Maki.


RESULTS
Sixty-five PICCs were removed after a median of 8.9 days. In five cases a catheter-associated significant colonisation with coagulase-negative staphylococci occurred. In two instances catheter-related bacteraemia was found.


CONCLUSIONS
In our study this catheter system was inserted in 94% of patients without problems and showed a low incidence of phlebitis (5/65). Because of the high rate of catheter malfunction reported during and after our study, the Olimpicc catheter is no longer available. The PICC system, and the LIFECATH-PICC(PUR)5FR in particular, offers a safe and effective alternative for central venous access to the internal jugular vein.
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology; D004866:Equipment Contamination; D019337:Hematologic Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000295:instrumentation*; D014182:Transplantation, Autologous / Q000295:instrumentation