Abstract CN21
Background
Intravenous oncological treatments often require permanent central venous access. We have opted for the PICC as the device of first choice for the administration of treatments in which the maintenance of venous access is not required beyond 1 year. The placement and care of these catheters is carried out in the onco-hematology day hospital by the Oncology Nursing.
Methods
All PICCs have been inserted in the Day Hospital for the administration of onco-hematological treatments. We have used a 3rd generation polyurethane PICC of Teleflex Medical®, 4Fr 1 Light, inserted by ultrasound-guided puncture using the modified Seldinger technique. We have a database for the prospective collection of variables concerning diagnosis, treatment, date of insertion and removal, reason for removal, vein of insertion chosen, its diameter and complications.
Results
From January 2015 to December 2020, we inserted 874 PICCs, with a total permanence of 110,848 days, and an average of 126 days per PICC. In 100% of the cases the insertion was successful, in 90% it was cannulated at the first attempt. Tumor type: breast cancer: 532 pt (60.9%), hematological: 81 pt (9.3%), colorectal: 75 pt (8.6%), gastric: 64 pt (7.3%), others: 97 pt (11.1%). Complications were recorded in 42 pt (4.8%): 22 arm thrombosis (2.5% or 0.19/1000 catheter days (CD)), 19 catheter obstructions (2.2% or 0.17/1000 CD) and 6 bacteremia catheter-related (BCR) (0.7% or 0.05/1000 CD). The main reasons for withdrawal were completion of treatment in 762 pt (91.9%), death in 66 pt (8%) and suspected BCR in 14 pt (1.7%), of which only 6 (0.7%) were confirmed with positive culture.
Conclusions
PICC is increasingly preferred over options because of its ease of placement and durability by experienced nurses. In our experience, the increase in its use is supported by the success rate of insertion and the low incidence of complications of less than 5%. Oncology Nursing are a good reference to lead the implementation of processes related to venous access in day hospitals.
Clinical trial identification
Editorial acknowledgement
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Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Objective
Consecutive registration of all PICCs inserted in our center since their implementation and evaluation of all events related to placement, complications, and reasons for removal.