An Overview of Peripherally Inserted Central Catheters

Leigh A. Bowe-Geddes, RN, BS, CRNI; Heather A. Nichols, RN, BSN, CRNI

Disclosures

Topics in Advanced Practice Nursing eJournal. 2005;5(3) 

In This Article

Indications for PICC Use

PICCs may be used for any infusate, regardless of osmolarity, pH, or other chemical properties of the solution or medication. With central tip termination, the blood flow around the catheter is high, usually 2 L or more per minute. This provides immediate dilution of the infusate and helps protect the vessel walls from chemical irritation by the prescribed therapy. Many intravenous medications and solutions cause damage to the peripheral venous endothelium and should be administered centrally to avoid this damage[8,9] ( Table 1 ).

A PICC is often the central VAD of choice, due to the lower incidence of infection compared with subclavian and internal jugular percutaneous catheters, and because there is no risk of pneumothorax with the PICC insertion procedure. The documented infection rate for PICCs is 0.75 infections per 1000 catheter days, compared with short-term (nonmedicated) central venous catheters at 2.51 infections per 1000 catheter days.[10] PICCs are also indicated for short-term infusions for patients with limited venous access and for therapies that will continue over long periods of time.

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