The Efficacy and Safety of Peripherally Inserted Central Catheters in Neuro Intensive Care Management: A Retrospective Study.

Abstract

Objective: This study aimed to analyze the efficacy and safety of peripherally inserted central catheters (PICCs) inserted by the PICC nursing team in the neuro intensive care unit (ICU).

Methods: A retrospective analysis was conducted on 756 patients admitted to the neuro ICU of a clinical neurosciences center in Shanghai, China, between January 2019 and December 2022. All patients required elective central venous access and had a PICC inserted by the PICC nursing team. Data on patient demographics, catheter type, insertion approach, puncture site, tip position, insertion success rate, and complications were extracted from electronic medical records using Questionnaire Star software. The study compared outcomes before and after the implementation of a specialized training program for the PICC nursing team, which included theoretical and practical training on PICC insertion techniques, maintenance, and complications management.

Results: Following the implementation of the trained PICC nursing team, significant changes were observed in catheter type and insertion technique. The use of 3-way valve Solo catheters and power-injectable open-ended catheters increased, while the use of 3-way valve catheters decreased. In addition, the use of ultrasound-guided modified Seldinger technique (MST) increased significantly, with a corresponding decrease in conventional PICC insertion and MST without ultrasound guidance. Malpositioned tips occurred in 6.3% of cases. Notably, after the implementation of the trained team, complications significantly decreased ( P <0.05) and the first-attempt success rate significantly increased ( P <0.05) compared with the period before the training program.

Conclusions: In neuro ICU patients, the use of PICCs inserted by a well-trained, competent PICC nursing team demonstrated improved outcomes, including reduced complications, increased first-attempt success rates, and higher quality of care. These findings highlight the importance of specialized training for PICC nursing teams in neurointensive care management.