From the Guidelines

To fix a clogged Peripherally Inserted Central Catheter (PICC) line, the most appropriate action is usually to attempt pharmacological clearance.

Identify the cause of the obstruction: The obstruction of a central venous catheter is most often due to intraluminal precipitate of lipid aggregates, drugs, clots, or contrast medium 1.
Choose the appropriate solution for clearance: The solution most adequate for the presumed type of obstruction should be used, such as ethanol for lipid aggregates, urokinase or recombinant tissue plasminogen activator (rTPA) for clots, NaOH or HCl for drugs, and NaHCO3 for contrast medium 1.
Use a 10 mL syringe or bigger: Clearance should always be performed using a 10 mL syringe (or bigger), so as to avoid inappropriate high pressures which may damage the catheter 1.
Consider exchange over a guide wire or removal: If pharmacological clearance is not successful, exchange over a guide wire or removal of the PICC line may be necessary 1.

Use appropriate nursing protocols: Intraluminal obstruction of the central venous access can be prevented by appropriate nursing protocols in maintenance of the line, including the use of nutritional pumps 1.
Flush the line regularly: Most central venous access devices for PN can be safely flushed and locked with saline solution when not in use 1.

Avoid using the PICC line for infusion of radiological contrast medium: This can cause damage to the external part of the catheter and increase the risk of complications 1.
Use a manufactured catheter stabilization device: This can help reduce the incidence of local complications at the exit site and the risk of dislocations 1.

From the Research

To fix a clogged PICC line, the following steps can be considered:

Assess the cause of the blockage, which may be due to malposition or migration of the catheter 2
Check for signs of infection, such as redness, swelling, or discharge at the insertion site 3
Consider using imaging techniques, such as chest X-ray or radiography, to confirm the position of the catheter and identify any potential complications 4, 5
If the catheter is malpositioned, it may be necessary to reposition or replace it to prevent further complications 2
In cases where the catheter is blocked due to a complication such as lymph vessel puncture, management strategies may involve assessing the amount and persistence of discharge, with removal indicated when symptoms persist or when the volume is excessive 6

When fixing a clogged PICC line, the following potential complications should be considered:

Catheter malposition, which can increase the risk of perforation, thrombus, and fistula formation 4
Infection, which can occur when the catheter is not properly inserted or maintained 3
Venous thrombosis, which can occur due to the presence of the catheter in the vein 5
Line fracture, which can occur due to mechanical stress on the catheter 5

Proper placement and maintenance of the PICC line are crucial to prevent complications and ensure safe usage:

Strict rules of handling and skilled operators are necessary to secure the safety of PICC usage 2
Cooperation from patients is also necessary to prevent complications and ensure proper maintenance of the catheter 2