The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter (PICC): A prospective cohort study

Sharp, Rebecca; Cummings, Melita; Fielder, Andrea; Mikocka‐Walus, Antonina; Grech, Carol; Esterman, Adrian

doi:10.1016/j.ijnurstu.2014.12.002

Cited by 143 publications

(98 citation statements)

References 23 publications

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“…In consequence, the classic rule stating that 'the size of catheter in French should not exceed the size of the vein in mm' [47] appears to be reasonably valid in pediatric patients. Recently, Sharp et al also reported an association between catheter/vein ratio and symptomatic PICC-related venous thromboembolism in adults, 0.45 being the optimal cut-off point [48]. According to Poiseuille's law, the higher the catheter/vein ratio the more stasis in venous flow, and, according to Virchow's triad, the higher the risk of thrombosis [41,49].…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children

Menéndez

Verdú

Calderon

et al. 2016

Journal of Thrombosis and Haemostasis

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Background Upper-extremity venous thrombosis is associated with the use of peripherally inserted central catheters (PICCs). Few pediatric studies have focused on this issue. Objectives To determine the incidence and risk factors for PICC-related superficial vein thrombosis (SVT) and deep vein thrombosis (DVT) in children. Patients/methods An observational follow-up cohort study was conducted at a single hospital between June 2012 and June 2015. All patients receiving a PICC were enrolled and followed up, with weekly Doppler ultrasound examination of the catheterized limb until PICC removal. Patient, procedural and follow-up data were analyzed. Results In the study period, 265 PICCs were inserted (median age of patients 6.5 years, interquartile range [IQR] 2.4-13 years; median weight 20 kg, IQR 11-38 kg; 54% males; 67.9% chronically ill), and patients were followed up for a total of 9743 days. The median indwelling time was 21 days (IQR 12-37 days). During follow-up, 88 (33.2% of insertions) PICC-related thromboses (incidence rate [IR] 9.03 per 1000 catheter-days) were diagnosed, 66 (24.9%) as isolated SVT, seven (2.6%) as isolated DVT, and 15 (5.7%) as SVT with associated DVT (IR 6.78, 0.71 and 1.54 per 1000 catheter-days, respectively). Only 9.9% of patients with SVT and 18.2% of those with DVT were symptomatic. The main risk factors for PICC-related SVT and DVT were a catheter/vein ratio of > 0.33 and thrombosis of the catheterized superficial vein, respectively. Conclusions PICC-related thrombosis is a common and nearly always asymptomatic complication in children, the SVT rate being approximately three times higher than the DVT rate. Optimal vein and catheter selection, yielding the lowest possible catheter/vein ratio, may decrease the rate of PICC-related thrombosis.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children

Menéndez

Verdú

Calderon

et al. 2016

Journal of Thrombosis and Haemostasis

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“…Vessels in the hand are located the most distal to the arm, and lumens of the blood vessels of the hand are smaller in diameter and walls of them are also thinner than those in forearms. On the other hand, antecubital fossa veins allow an easier access, larger needles for blood sampling, a reduced chance of vessel collapse (Heyer et al, ) and a better catheter‐to‐vein ratio of 45% or less to prevent venous thrombosis (Sharp et al, ). That is the reason that antecubital fossa is the most site for venipuncture as well (Yamada, Yamada, Katsuda, & Hida, ).…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, antecubital fossa veins allow an easier access, larger needles for blood sampling, a reduced chance of vessel collapse (Heyer et al, 2012) and a better catheter-to-vein ratio of 45% or less to prevent venous thrombosis (Sharp et al, 2015). That is the reason that antecubital fossa is the most site for venipuncture as well (Yamada, Yamada, Katsuda, & Hida, 2008).…”

Section: Discussionmentioning

confidence: 99%

Comparisons of laboratory results between two blood samplings: Venipuncture versus peripheral venous catheter—A systematic review with meta‐analysis

Jeong

Park

Jung

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To compare the results of haematology, blood chemistry and coagulation tests between two blood sampling methods via venipuncture and peripheral venous catheter. Background Laboratory results of the previous studies on blood sampling methods through peripheral venous catheter versus venipuncture are inconsistent. Therefore, it is necessary to better understand the discrepancies between the two blood sampling methods and to provide evidence for practice. Design Systematic literature review and meta‐analysis were conducted in accordance with the PRISMA reporting guideline. Methods Reviewed articles for this study were searched through database, including PubMed, Cochrane Library, EMBASE, SCOPUS, Web of Science, ProQuest Dissertations & Theses, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and ERIC (Educational Resource Information Centre). Hand‐searching was also conducted. Results We finally identified 17 studies for a systematic review, and 10 studies out of them were selected for a meta‐analysis. A total of 678 participants were included in the meta‐analysis. Overall, there was no significant difference in haematology, blood chemistry and coagulation test values between two sampling methods via venipuncture and peripheral venous catheter. Conclusion Findings of this study provide substantial evidence that most blood tests via venipuncture and peripheral venous catheter would not be different. Patients will be benefitted by reducing the number of venipuncture if a series of blood tests can be conducted by using peripheral venous catheter. Thus, healthcare providers may refer to more reliable laboratory results on using peripheral venous catheter for without increasing the risk of bleeding events and pain on blood sampling sites due to frequent phlebotomies. Relevance to clinical practice The results of this study will be a good evidence to decide blood sampling methods in clinical practice.

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“…Peripherally inserted central catheter complications are more likely when the ratio of catheter diameter to vein diameter increases . The use of a jugular vein spares peripheral veins that may be crucial for future fistulas.…”

Section: Discussionmentioning

confidence: 99%

Don't Pick the PICC

2019

AORN Journal

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The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter (PICC): A prospective cohort study

Cited by 143 publications

References 23 publications

Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children

Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children

Comparisons of laboratory results between two blood samplings: Venipuncture versus peripheral venous catheter—A systematic review with meta‐analysis

Don't Pick the PICC

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