title: Use of peripherally inserted central catheters as an alternative to central catheters in neurocritical care units.
abstract: BACKGROUND
  Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings.
  
  
  METHODS
  Data on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage.
  
  
  RESULTS
  Complete data were available on 33 patients with Hunt-Hess grade IV-V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 days (mean, 19 days; range, 4-64 days). One patient (3%) had deep vein thrombosis in an upper extremity. In 2 patients, central venous pressure measured with a peripherally inserted catheter was higher than pressure measured concurrently with a central venous catheter. None of the 33 patients had a central catheter bloodstream infection or persistent insertion-related complications. CONCLUSIONS Use of peripherally inserted central catheters rather than central venous catheters or pulmonary artery catheters in the neurocritical care unit reduced procedural and infection risk without compromising patient management.
authors: Department of Neurological Surgery, University of California, Davis, USA. christi.delemos@ucdmc.ucdavis.edu
authors: Christi
authors: C
authors: DeLemos
authors: Judy
authors: J
authors: Abi-Nader
authors: Paul T
authors: PT
authors: Akins
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000451:nursing*; D002406:Catheterization, Peripheral / Q000451:nursing*; D002408:Catheters, Indwelling / Q000009:adverse effects; D003422:Critical Care / Q000379:methods; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000451:nursing*; D011446:Prospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000451:nursing; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000451:nursing