Research study: Valved versus open PICC occlusion rates

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Johnston, A.J., Streater, C.T., Noorani, R., Crofts, J.L., Del Mundo, A.B. and Parker, R.A. (2012) The effect of peripherally inserted central catheter (PICC) valve technology on catheter occlusion rates – The ‘ELeCTRiC’ study. The Journal of Vascular Access. April 2nd [Epub ahead of print].

Abstract:

Purpose: Peripherally Inserted Central Catheters (PICCs) are increasingly being used to provide short to medium-term central venous access. The current study was designed to test the hypothesis that PICC valve technology does not influence PICC occlusion rates.

Methods: Intensive care unit (ICU) patients who required a PICC were randomized to one of three types of dual lumen PICC (open ended non-valved, Groshong valve, PASV valve). PICC occlusions were recorded and managed with a protocol that used urokinase.

Results: A total of 102 patients were recruited to the study. The overall risk of occlusion per catheter was 35% (95% CI 26% to 44%). The overall rate of occlusion was 76 occlusions per 1000 catheter days (95% CI 61 to 95). Presence or type of valve did not significantly influence this rate (open-ended non-valved PICC 38% of catheters, 79 occlusions per 1000 catheter days; Groshong 38% of catheters, 60 occlusions per 1000 catheter days; PASV 27% of catheters, 99 occlusions per 1000 catheter days). The dose of urokinase required to treat PICC occlusions did not significantly differ between PICC types.

Conclusions: Valved PICCs do not appear to influence PICC occlusion rates.

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