AN AUDIT FOR PERIPHERALLY INSERTED CENTRAL CATHETER AT TERTIARY CARE CENTER

INTRODUCTION: Venous access is a critical issue in the care and management of wide variety of patients. The insertion of central venous catheters for patients requiring long-term venous access is now common. Peripherally inserted central catheters provide effective short- and intermediate term intravenous access in patients requiring therapies like IVantibiotics, chemotherapy, hyperalimentation and administration of other medications. PICCs have several potential advantages, including use of local anesthesia, a low risk of major hemorrhage, and no risk of pneumothorax. PICCs are now increasingly placed by interventional radiologists in angiography suite. With use of fluoroscopic and ultrasound guidance higher success rates are achieved as compared to bedside placement of these catheters. The aim of this study was to evaluate the success and immediate complication rates of radiologically guided PICC line insertion. PATIENTS AND METHODS: Six months data was retrospectively evaluated of patients who underwent PICC insertion in interventional radiology suit of our department. All procedures were performed under strict aseptic measures after infiltrating local anesthesia. 4 Fr single lumen catheters were inserted in all patients under fluoroscopy guidance after ultrasound guided puncture of an arm vein. Clotting parameters of all patients were assessed prior to venous puncture. Tip of the catheters were placed in distal third of superior vena cava. RESULTS: A total of 416 PICC lines were inserted in 337 patients over the study period. 279 (82.7%) patients underwent single insertion and 58 (17.2%) patients underwent multiple insertions of PICC. Among these 58 patients who had multiple insertions total 137 (32.9%) PICC lines were placed. Success rate for PICC insertion was 99.52%. Immediate complication rate for insertion of PICC was 0.48%. CONCLUSION: Radiologically guided placement of PICC by interventional radiologists is a simple, safe and effective procedure in patients requiring long term venous access.