What is a PICC Line?
A PICC (Peripherally Inserted Central Catheter) line is a long, thin, flexible catheter inserted through a peripheral vein in the arm (basilic, brachial, or cephalic vein) that extends centrally with its tip positioned in the superior vena cava, providing central venous access for intermediate-term therapy. 1
Physical Characteristics
- Length: 50-60 cm long 1
- Diameter: Ranges from 2F to 7F 1
- Material: Typically made of silicone or polyurethane (PUR) 1
- Lumens: Available with one, two, or three lumens 1
- Tip position: Must be positioned at the superior vena cava-right atrium junction 2
Insertion Site and Technique
PICCs are inserted through peripheral veins of the arm, specifically the basilic, brachial, or cephalic veins, distinguishing them from traditional central venous catheters that require direct puncture of central veins like the subclavian or internal jugular. 1 This peripheral insertion approach is associated with fewer mechanical complications at insertion compared to centrally inserted catheters. 1
Duration of Use
PICCs are classified as intermediate-term central venous access devices designed for use up to 3 months. 1 They are nontunneled devices specifically intended for prolonged intermittent or continuous infusion therapies in both hospitalized and outpatient settings. 1
Clinical Indications
PICCs are appropriate for multiple therapeutic and diagnostic purposes:
- Parenteral nutrition administration 1, 3
- Chemotherapy delivery 1, 3
- Long-term antibiotic therapy 3
- Blood product transfusion 3
- Intravenous medications and fluids 1
- Repeated blood sampling 1, 3
Advantages Over Other Central Access Devices
PICCs offer several clinical advantages: fewer mechanical complications at insertion, lower insertion costs, and potentially lower infection rates compared to centrally inserted catheters. 1 The antecubital fossa or midarm exit site removes the catheter further from endotracheal, oral, and nasal secretions, reducing contamination risk. 1
Key Limitations
The exit position in the arm effectively disables one hand, which may make self-care difficult for patients requiring home parenteral nutrition. 1 For therapy expected to last longer than 6 months, tunneled catheters or implantable ports are preferred over PICCs. 2
Safety Profile
PICCs are associated with relatively low rates of catheter-related bloodstream infections compared to other central venous access devices. 1, 2 The infection rate in acute care settings is approximately 2.2%. 4 However, complications including thrombosis, infection, displacement, and occlusion can occur and require appropriate monitoring. 5, 6