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Vulnerable patients have same CLABSI risk with PICCs

Peripherally inserted central catheters do not reduce the risk of central line-associated bloodstream infections in hospitalized patients when compared with other central venous catheters, despite being considered safer, a new study found.

PICCs have become one of the most commonly used central venous catheters in healthcare settings because they are considered easier and safer to use, with a lower risk of CLABSIs. The study, published in the September issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, shows the risk of CLABSI with PICCs is based more on patient factors than the device.

“As the use of PICCs has grown exponentially in vulnerable populations, caution and close evaluation of risks and benefits is warranted when using the device,” Vineet Chopra, MD, MSc, the study’s lead author and assistant professor of medicine at the University of Michigan Health System, said in a news release. “This research provides novel ideas for advancing both clinical practice and science around the use of these devices.”

After noticing many of the original studies on PICC bloodstream infection rates included nonhospitalized patients, the researchers hypothesized that selection of healthier patients might explain the lower risk of CLABSI observed with PICCs. Chopra and colleagues conducted a systematic review and meta-analysis of 23 studies of PICCs to compare the risk of CLABSIs between PICCs and other noncuffed, nontunneled central venous catheters.

Their analysis involved 57,250 patients and found hospitalized patients with PICCs were as likely to develop bloodstream infection as were patients with other types of central venous catheters. However, the authors found nonhospitalized patients in outpatient settings appeared to fare better with PICCs than other devices.

The authors suggest using proven prevention strategies that have been employed in ICUs to reduce CLABSIs in non-critical care settings. They said the study also highlights the need for future research assessing the role of novel technologies and practices, such as chlorhexidine-impregnated site dressings and antimicrobial PICCs.

Study abstract: www.jstor.org/stable/10.1086/671737.

By | 2013-08-09T00:00:00-04:00 August 9th, 2013|Categories: Nursing specialties, Specialty|0 Comments

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