A team-based multidisciplinary approach to managing peripherally inserted central catheter complications in high-risk haematological patients: a prospective study.
OBJECTIVE
Use of peripherally inserted central catheters (PICCs) has markedly increased during the last decade. However, there are few studies on use of PICCs in patients with haematological malignancies (HM) receiving intensive chemotherapy. Preliminary data suggest a higher rate of PICC-related complications in these high-risk patients. This prospective observational single-centre study aimed to investigate PICC-related complications after implementation of a multidisciplinary approach to PICC care and compared it with previous literature.


METHODS
A total of 44 PICCs were inserted in 36 patients (27.3%, thrombocytopenia <50 × 10(9)/L at insertion) over 5045 PICC days (median duration, 114.5 days).


RESULTS
No major insertion-related complications were observed. Major late complications were obstruction in 13.6% (1.19/1000 PICC days) of patients, catheter-related bloodstream infection in 6.8% (0.59/1000 PICC days), and catheter-related thrombosis in 4.5% (0.39/1000 PICC days). Premature PICC removal occurred in 34% (2.97/1000 PICC days) of patients. The overall rate of potentially major dangerous complications was particularly low (11.36%, 0.99/1000 PICC days) compared with previous studies.


CONCLUSIONS
This study highlights the utility of a multidisciplinary approach for PICC care in adults with HM receiving intensive chemotherapy. We provide further data to support use of PICCs in such patient populations.
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain. natcurto@gmail.com.
Natalia
N
Curto-García
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Julio
J
García-Suárez
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Marta
M
Callejas Chavarria
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Juan José
JJ
Gil Fernández
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Yolanda
Y
Martín Guerrero
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Elena
E
Magro Mazo
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Shelly
S
Marcellini Antonio
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Luis Miguel
LM
Juárez
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Isabel
I
Gutierrez
Nursing Staff of the Haematology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Juan José
JJ
Arranz
Nursing Staff of the Haematology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Irene
I
Montalvo
Nursing Staff of the Haematology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Carmen
C
Elvira
Nursing Staff of the Haematology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Pilar
P
Domínguez
Nursing Staff of the Haematology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
María Teresa
MT
Díaz
Department of Haematology, University Hospital Príncipe de Asturias, Carretera Alcalá- Meco s/n, Alcalá de Henares, Madrid, Spain.
Carmen
C
Burgaleta
D000293:Adolescent; D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*; D055815:Young Adult
Haematological malignancies; PICC-related bloodstream infection; PICC-related thrombosis; Peripherally inserted central catheters