title: Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study.
abstract: OBJECTIVE
  Few prospective follow-up studies evaluating the use of peripherally inserted central catheters (PICCs) to deliver chemotherapy and/or home parenteral nutrition (HPN) have focused exclusively on oncology outpatients. The aim of this prospective study was to assess the reliability and the safety of PICCs over a 5-year use in non-hospitalized cancer patients requiring long-term intravenous therapies.
  
  
  METHODS
  Since June 2008, all adult oncology outpatient candidates for PICC insertion were consecutively enrolled and the incidence of catheter-related complications was investigated. The follow-up continued until the PICC removal.
  
  
  RESULTS
  Two hundred sixty-nine PICCs in 250 patients (98 % with solid malignancies) were studied, for a total of 55,293 catheter days (median dwell time 184 days, range 15-1,384). All patients received HPN and 71 % received chemotherapy during the study period. The incidence of catheter-related bloodstream infections (CRBSIs) was low (0.05 per 1,000 catheter days), PICC-related symptomatic thrombosis was rare (1.1 %; 0.05 per 1,000 catheter days), and mechanical complications were uncommon (13.1 %; 0.63 per 1,000 catheter days). The overall complication rate was 17.5 % (0.85 per 1,000 catheter days) and PICCs were removed because of complications only in 7 % of cases. The main findings of this study were that, if accurately managed, PICCs can be safely used in cancer patients receiving chemotherapy and/or HPN, recording a low incidence of CRBSI, thrombosis, and mechanical complications; a long catheter life span; and a low probability of catheter removal because of complications.
  
  
  CONCLUSIONS
  Our study suggests that PICCs can be successfully utilized as safe and long-lasting venous access devices in non-hospitalized cancer patients.
authors.affiliation: Anesthesiology and Intensive Care, Unit of Parenteral Nutrition in Oncology, Department of Medicine, S. Giovanni Battista Hospital, University of Turin, Via Giovanni Giolitti 9, 10123, Turin, Italy, paolo.cotogni@unito.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cotogni
authors.forename: Cristina
authors.initials: C
authors.lastname: Barbero
authors.forename: Cristina
authors.initials: C
authors.lastname: Garrino
authors.forename: Claudia
authors.initials: C
authors.lastname: Degiorgis
authors.forename: Baudolino
authors.initials: B
authors.lastname: Mussa
authors.forename: Antonella
authors.initials: A
authors.lastname: De Francesco
authors.forename: Mauro
authors.initials: M
authors.lastname: Pittiruti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D062905:Central Venous Catheters / Q000009:adverse effects*; D004358:Drug Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D016331:Parenteral Nutrition, Home / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D015203:Reproducibility of Results; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology