Abstract 1508P
Background
The purpose of this study was to investigate whether routine insertion of PICC at the time of admission of hospice-palliative care (HPC) unit would be acceptable in regards of safety and efficacy, and superior in patients’ satisfaction compared to those of usual intravenous (IV) access.
Methods
Terminally ill cancer patients were randomly assigned to two arms: 1) routine PICC arm (initially insertion of PICC at HPC unit), 2) usual IV access arm (maintenance of peripheral line until 3≥trials a day, and late insertion of PICC) between May 2017 and January 2020. We monitored the occurrence of PICC related complication and evaluated the patient-perceived satisfaction for IV access using semi-structured questionnaire (5 ratings, range from ‘much discomfort’ to ‘much comfort’). The primary endpoint is IV maintenance success rate, which is rate of functional IV maintenance until intended time (discharge, transfer, or death).
Results
In the routine PICC arm (n=29), mean time to PICC was 0.84 (0-3) days, 27 patients maintained PICC with function until intended time, and the other 2 prematurely removed due to delirium related self-removal. In the usual IV arm (n=28), 11 patients maintained peripheral Iline, 15 patients underwent PICC (8.65 (6-18) days), excluding 2 failed patients. In summary, IV maintenance success rate in the routine PICC (27/29, 93%) was similar with that in the usual IV (26/28, 93%, p= 0.958). Patients’ satisfaction at 5th day was better in the routine PICC (97% as ‘a little comfort’ or ‘much comfort’) compared with that in the usual IV (21%) (p<0.001). The median catheter life span was 16 (7-60) days in the routine PICC and 8 (1-34) days in the usual IV. Table: 1508P
Result of IV access
| Characteristics | Routine PICC (N=29) | Usual IV access (N=28) | P-value |
| Peripheral IV maintenance until intended time | N/A | 11 | |
| PICC insertion failed | 0 | 2 | |
| Causes of PICC removal | |||
| Deaths | 23 | 13 | |
| Transfer to another hospital | 4 | 2 | |
| Self-removal | 2 | 0 | |
| IV maintenance success rate | 93.1% | 92.8% | 0.958 |
Conclusions
Routine PICC insertion in terminally ill cancer patients showed similar safety and efficacy and superior satisfaction compared with usual IV access. Thus, routine PICC insertion should be considered at admission to HPC unit.
Clinical trial identification
NCT03299868; release date, October 3, 2017.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.