From the Guidelines
Yes, a PICC line is considered a type of central line. Despite being inserted through a peripheral vein, typically in the upper arm, a PICC line's tip terminates in a central vein near the heart, usually the superior vena cava, which classifies it as a central line 1. This classification is crucial because PICC lines are associated with the same risks as traditional central venous catheters, including central line-associated bloodstream infections and venous thromboembolism 1.
Key Characteristics of PICC Lines
- They are used for extended intravenous therapy, including administration of antibiotics, chemotherapy, parenteral nutrition, and for patients who need frequent blood draws.
- They can remain in place for weeks to months, unlike standard peripheral IVs which typically last only a few days.
- PICC lines require special care to prevent complications such as infection, blood clots, or catheter migration, including regular flushing, sterile dressing changes, and proper securement.
Clinical Implications
The management and care of PICC lines should follow the same protocols as traditional central lines to minimize the risk of complications. This includes the use of ultrasound-guided venepuncture for insertion, placement of the catheter tip in the lower third of the superior vena cava, and adherence to strict infection control measures such as maximal barrier precautions during insertion and regular disinfection of hubs and connectors 1.
Recommendations for Practice
- PICC lines should be used judiciously, considering the potential benefits and risks for each patient, and their use should be guided by evidence-based protocols to minimize complications.
- The choice of catheter material, while important, has limited evidence suggesting a significant impact on catheter-related sepsis, with current catheters being made from materials like polyurethane or silicone 1.
- Regular education and training of staff on the appropriate insertion, maintenance, and removal of PICC lines are crucial to reducing the risk of catheter-related infections and other complications.
From the Research
Definition of PICC and Central Line
- A Peripherally Inserted Central Catheter (PICC) line is a type of central venous catheter that is inserted into a peripheral vein of the arm to obtain intravenous central access 2.
- Central Venous Catheters (Central lines) are used for the rapid administration of drugs, chemotherapy, nutritional support, blood components, and monitoring patients 3.
Comparison of PICC and Central Line
- PICC lines are an alternative option for Central Venous Catheter (CVC) access, with the aim of reducing complications associated with large vein cannulation 3, 4.
- The choice between PICC and CVC does not affect the position of the catheter tip, and both are equally effective for central venous access and CVP measurements 4.
Use of PICC Lines
- PICC lines are frequently used in medical settings, including neonatal intensive and high-dependency care, for the delivery of medications, parenteral nutrition, and other purposes 5.
- The insertion of PICC lines can be performed by certified registered nurses, and the procedure has undergone many changes since its introduction in the early 1950s 6.
Key Characteristics of PICC Lines
- PICC lines are soft, flexible catheters made of polyurethane or silicone, inserted via an upper or lower extremity peripheral vein into the superior or inferior vena cava 6.
- The use of PICC lines has several advantages and disadvantages, and complementary devices are necessary during the procedure 6.