Safety and effectiveness of tunneled peripherally inserted central catheters versus conventional PICC in adult cancer patients.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2024-12-01 Epub Date: 2024-06-28 DOI:10.1007/s00330-024-10852-y

Jia Li, Zeyin Hu, Mengna Luo, Zhenming Wu, Xinman Dou, Zhiying Wang, Shuang Yu, Liping Xiao, Jinhua Qiu, Shuxian Yu, Mengyun Chen, Suxiang Lu, Binglian Su, Li Cheng, Yuying Fan, Hui-Ying Qin

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引用次数: 0

Abstract

Objectives: This study aimed to compare the safety and effectiveness of tunneled peripherally inserted central catheters (T-PICC) vs. conventional PICCs (C-PICC) in adult cancer patients.

Methods: A multicentre randomized controlled trial was conducted between April 2021 and January 2022 in seven hospitals in China. 564 participants were randomly assigned to T-PICC or C-PICC. These data were collected and compared: the baseline characteristics and catheterization-related characteristics, periprocedural complications, and long-term complications.

Results: Five-hundred fifty-three participants (aged, 52.6 ± 12.3 years; female, 39.1%) were ultimately analyzed. No significant differences in periprocedural complications were found between the T-PICC and C-PICC groups (all p > 0.05). Compared with C-PICC, T-PICC significantly reduced the incidence of long-term complications (26.4% vs. 39.9%, p < 0.001). Specifically, reduced complications were found in central line-associated bloodstream infection (1.8% vs. 5.1%, p = 0.04), thrombosis (1.1% vs. 4.0%, p = 0.03), catheter dislodgement (4.7% vs. 10.1%, p = 0.01), non-infectious oozing (17.3% vs. 28.6%, p = 0.002), local infection (3.6% vs. 7.6%, p = 0.04), skin irritation (6.1% vs. 10.9%, p = 0.046), and reduced unplanned catheter removal (2.2% vs. 7.2%, p = 0.005). No significant differences were found between T-PICC and C-PICC regarding catheter occlusion (6.5% vs. 5.8%, p = 0.73) or skin damage (2.2% vs. 2.9%, p = 0.58).

Conclusion: T-PICC is safe and effectively reduces long-term complications.

Clinical relevance statement: The tunneled technique is effective in reducing PICC-related long-term complications. Thus, it is recommended for cancer patients at high risk of PICC-related complications.

Trial registration: The registration number on https://www.chictr.org.cn/ is ChiCTR2100044632. The name of the trial registry is "A multicenter randomized controlled study of clinical use of tunneled vs. non-tunneled PICC".

Key points: Cather-related complications are associated with the technique of catheterization. Compared with conventional PICC, tunneled PICC reduced catheter-related long-term complications. Tunneled PICC placement provides an alternative catheterization method for cancer patients.

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成人癌症患者使用隧道式外周置入中心导管与传统 PICC 相比的安全性和有效性。

研究目的本研究旨在比较隧道式外周置入中心导管（T-PICC）与传统 PICC（C-PICC）在成人癌症患者中的安全性和有效性：方法：2021 年 4 月至 2022 年 1 月期间，在中国七家医院开展了一项多中心随机对照试验。564 名参与者被随机分配到 T-PICC 或 C-PICC。试验收集并比较了基线特征、导管相关特征、围手术期并发症和长期并发症等数据：最终对 553 名参与者（年龄为 52.6 ± 12.3 岁；女性占 39.1%）进行了分析。T-PICC组和C-PICC组的围手术期并发症无明显差异（P均>0.05）。与 C-PICC 相比，T-PICC 显著降低了长期并发症的发生率（26.4% 对 39.9%，P 结论：T-PICC 是一种安全、有效的手术方法：T-PICC是安全的，能有效减少长期并发症：隧道技术可有效减少与 PICC 相关的长期并发症。因此，建议PICC相关并发症高风险癌症患者采用该技术：https://www.chictr.org.cn/ 上的注册号为 ChiCTR2100044632。试验登记的名称为 "隧道式与非隧道式 PICC 临床应用的多中心随机对照研究"：要点：导管相关并发症与导管技术有关。与传统的 PICC 相比，隧道式 PICC 减少了导管相关的长期并发症。隧道式 PICC 置管术为癌症患者提供了另一种导管植入方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.