Chopra V, et al. - During this study, experts gauged the correlation between peripherally inserted central catheters (PICCs) exchange and the risk of thromboembolism. A possible connection was revealed between guidewire exchange of PICCs with the increased risk of thrombosis. Data warranted the consideration of risks and benefits of exchanges in clinical practice since certain exchanges could be preventable.

Methods

• The design of this research was a retrospective cohort study.
• The eligible candidates included adult hospitalized patients that received a PICC during clinical care one of 51 hospitals participating in the Michigan Hospital Medicine Safety consortium.
• Hazard of symptomatic venous thromboembolism (radiographically confirmed upper-extremity deep vein thrombosis and pulmonary embolism) in enrollees that underwent PICC exchange vs those that did not, served as the primary outcome.

Results

• A total of 589 candidates (2.6%) experienced a PICC exchange, among 23,010 patients that underwent PICC insertion in the study.
• It was reported that approximately half of all exchanges were conducted for catheter dislodgement or occlusion.
• PICC-associated deep vein thrombosis was experienced by 480 patients (2.1%).
• Greater incidence of deep vein thrombosis was discovered in enrollees that underwent PICC exchange vs those that did not (3.6% vs 2.0%, p < 0.001).
• Findings revealed shorter median time to thrombosis among those that underwent exchange compared vs those that did not (5 vs 11 days, p=0.02).
• Data shed light on an independent link between PICC exchange with two-fold greater risk of thrombosis (hazard ratio [HR]=1.98, 95%CI=1.37-2.85) vs no exchange, after adjustment.
• It was deduced that the effect size of PICC exchange on thrombosis was second in magnitude to device lumens (HR=2.06 [95%CI=1.59-2.66] and HR=2.31 [95%CI=1.6-3.33] for double- and triple lumen devices, respectively).