Peripherally inserted central catheter
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A peripherally inserted central catheter (PICC or PIC line) is a form of intravenous access that can be used for a prolonged period of time, e.g. for long chemotherapy regimens, extended antibiotic therapy or total parenteral nutrition. First described in 1975,[1] it is an alternative to subclavian lines, internal jugular lines or femoral lines which have higher rates of infection. Subclavian and internal jugular line placements may result in pneumothorax (air in the pleural space of lung).
A PICC is inserted in a peripheral vein, such as the cephalic vein, basilic vein, or brachial vein and then advanced through increasingly larger veins, toward the heart until the tip rests in the distal superior vena cava or cavo-atrial junction.
PICCs are usually inserted by radiologists, physician assistants, radiologist assistants, or certified registered nurses using ultrasound, chest radiographs and fluoroscopy to aid in their insertion and to confirm placement. Complications may include catheter occlusion, phlebitis, hemorrhage, thrombosis and infection. Urokinase may be used to lyse obstructions. PICC lines generally will remain in place no longer than 30 days, although duration of use varies from just a few days in patients requiring short courses of chemotherapy or biotherapy to a year for patients requiring longer treatment. Commonly, other forms of intravenous access are considered if the treatment course is protracted. While replacement is generally considered a year post-insertion, patients have survived with the same PICC in situ for several years without complication.
Certain types of PICCs have recently been approved by the FDA for use in power injection. These PICCs, often referred to as "POWER PICCs", are designed to withstand the high pressures associated with radiocontrast studies.
Notes
References
- Bender, C.M., Rosenzweig, M. & Green, E. (2006) Cancer. In S. Goldsworthy & M.A. Barry. Medical-Surgical Nursing in Canada: Assessment and Management of Clinical Problems. (1st Canadian ed). Mosby: Toronto. ISBN 0779699696.
External links
Manufacturer websites
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
