Trimming PICCs and the incidence of upper extremity deep vein thromboses

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“The purpose of this study was to determine whether an association exists between cutting or trimming peripherally inserted central catheters (PICCs) and the development of deep vein thromboses (DVTs).” Steele and Norris (2014).

Reference:

Steele, D. and Norris, C.M. (2014) Cutting peripherally inserted central catheters may lead to increased rates of catheter-related deep vein thrombosis. Journal of Infusion Nursing. 37(6), p.466-72.

Abstract:

The purpose of this study was to determine whether an association exists between cutting or trimming peripherally inserted central catheters (PICCs) and the development of deep vein thromboses (DVTs). An observational, retrospective study was conducted on 634 patients who had a PICC inserted between 2011 and 2012. Patients who had a reverse-taper PICC inserted were assigned into 1 of 2 groups. The first group included patients with a reverse-taper PICC that was cut/trimmed (PC) before insertion (n = 224). The second group was made up of patients whose PICC was not cut/trimmed (PNC) before insertion (n = 410). All PICC-associated DVTs were confirmed by a positive venous Doppler result and recorded. A statistically significant difference (P < .001) was found between patients in the PC group who developed a DVT (9.82%) and patients in the PNC group in which PICCs were not trimmed (1.95%). There is evidence to suggest that altering the reverse-taper PICC by cutting or trimming the tip before insertion may be associated with increased DVTs. Further study is required to determine whether PICCs should be reduced in length or whether there is an appropriate method of trimming the catheter to ensure its stability after insertion.

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