SAN ANTONIO, Tex.–A peripherally inserted central catheter (PICC) with preclinical data claiming antithrombogenic and antimicrobial properties failed to reduce the rate of central line bloodstream infection (CLABSI) or catheter-related thromboses compared with a standard PICC, a study presented at the ONS 41st Annual Congress has shown.1
“At our cancer center, efforts to reduce and maintain CLABSI rates below NHSN benchmarks in our Adult Leukemia and Bone/Barrow Transplant (ALBMT) patients were successful,” said Karen Abbas, MS, RN, AOCN, a service educator at Wilmot Cancer Institute in Rochester, New York. “However, the rate of PICC-associated thromboses, the use of alteplase to restore patency, and line dysfunction continued to be unacceptable.”
Because these factors cause delays in treatment, increase health care costs, and negatively impact nursing times, staff at URMC sought to investigate whether the implementation of a new product would reduce the rate of thromboses and line dysfunction while maintaining the low rate of CLABSI.
They identified a Food and Drug Administration (FDA)-approved PICC that had preclinical data suggesting antithombogenic and antimicrobial properties to evaluate in 75 patients admitted to the ALBMT Services. Of note, the PICC had chlorexidine gluconate on it so patients with allergy to that substance were excluded. Patients either underwent placement of the investigational PICC or the standard PICC in their upper forearm.
Results of the study showed that the CLABSI rate and frequency of line-associated bleeding were the same in both cohorts. In addition, 55% of the investigational PICCs required alteplase for occlusion compared with 59% of the standard PICCS.
The researchers observed a lower incidence of deep vein thrombosis compared with the new device. A total of 17% of patients with the investigational PICC developed catheter-related thromboses vs 9% of those who had the standard PICC.
Therefore, “we could not recommend the study PICC as there was no apparent advantage and staff satisfaction with performance and ease of use was greater with the current PICC,” Abbas concluded.
The ALBMT nurses are currently considering another available PICC with antithrombogenic properties for assessment.
1. Abbas K, Adair N, Conderman E, et al. Quality initiative aimed at reduction of peripherally inserted central catheter associated thromboses and line dysfunction. Oral presentation at: 2016 Oncology Nursing Society Annual Congress; April 28-May 1, 2016; San Antonio, TX.