Establishment of peripherally inserted central catheter line clinic at a tertiary care hospital: Review of first 100 cases

Abstract

Objectives: Peripherally inserted central catheter (PICC) lines are increasingly being used as a reliable central venous access in the management of patients on long-term intravenous medications. These are usually placed by different specialists; however, an intensivist-driven PICC line program with a dedicated clinic covering outpatient chemotherapy patients is an added avenue to our subspecialty. We share our experience of starting a PICC line clinic in our hospital and developing the team for insertion, maintenance, and troubleshooting of PICC lines, so to make this procedure smooth and complication free. Materials and Methods: We conducted a retrospective cross-sectional study of the first 100 consecutively placed PICC lines by intensivists at our hospital with our experience of starting a PICC line clinic. We analyze the success rates of PICC line placement under ultrasound guidance, also reporting complications encountered. Results: The initial 100 PICC lines placed in 92 patients during the 2-year study period having catheter days of 8674 days were analyzed. All the PICC lines were successfully placed (100%), the majority on chemotherapy patients (84%). A total of 39 complications were found in 16 patients, at a rate of 4.49/1000 catheter days; out of which only 2 (2%) cases had infection with septicemia. None of the 12 patients in the intensive care unit with catheter days of 164 days had any catheter-induced infection. Conclusions: Ultrasound-guided PICC line placement by an intensivist is a safe method in patients requiring prolonged intravenous medication. PICC line clinic increases awareness among such patients and makes the procedure with afterward care more standardized.