The incidence rate and determinants of thrombotic occlusion of power injectable peripherally inserted central catheters at the WRHA community intravenous infusion clinics in Winnipeg, Manitoba
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Date
2020-11-23
Authors
Guler-Berk, Hatice
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Abstract
Abstract
Power-injectable (PI) peripherally inserted catheters (PICCs) have been used frequently in community settings as they provide a reliable central venous access to infuse intravenous infusates. However, these catheters can occlude. Thrombotic occlusion is the most frequent complication of PICCs. A retrospective cohort study was conducted to investigate the incidence rate and the determinants of PI PICCs at the Winnipeg Regional Health Authority (WRHA) Community IV Program (CIVP) IV Infusion Clinics in Winnipeg, Manitoba. Data was extracted from electronic patient charts housed in Accuro Electronic Medical Record at the WRHA CIVP IV Infusion Clinics. Survival analysis methods were used to analyze data. Cox proportional hazards models were used to assess the association between thrombotic occlusion and certain socio-demographic, clinical, insertion and PI PICC-related characteristics. The incidence rate of thrombotic PI PICC occlusion was 32 per 1,000 person-weeks (95% CI: 25-43). After adjusting for IV antimicrobials, ambulatory drug delivery pump use, the tip location of PI PICCs, and the number of PI PICC lumens, the hazard of thrombotic occlusion for those PI PICCs which received IV vancomycin was 5.8 times greater (95% CI: 2.8-12.3).
The hazard of thrombotic occlusion was 5.1 times greater (95 % CI: 2.8-9.1) when
multiple-lumen PI PICCs used.
To reduce the incidence rate of thrombotic occlusion, single-lumen PI PICCs should be used whenever possible. Heparin lock may be used to lock multiple-lumen PI PICCs and when IV vancomycin is infused. Further research with a greater sample size is needed to validate the findings of this study. Keywords: power injectable peripherally inserted central catheters, peripherally inserted central catheters, thrombotic occlusion, withdrawal occlusion, community-based IV infusion clinic, infusion nursing.
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Keywords
Peripherally inserted central catheters, Withdrawal occlusion, Thrombotic occlusion, Community-based intravenous infusion clinic, Infusion nursing, Power Injectable peripherally inserted central catheters