Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Aus der Praxis – für die Praxis

Arten und Häufigkeiten von Komplikationen bei Midline-Kathetern und PICCs in einem Südtiroler Bezirkskrankenhaus – eine retrospektive Kohortenstudie

Published Online:December 07, 2018https://doi.org/10.1024/1012-5302/a000654

Abstract

Zusammenfassung.Hintergrund: Bei der Insertion und Pflege peripher eingeführter Zentralvenenkatheter (Peripherally Inserted Central venous Catheters / PICCs) und Midline-Katheter spielen in angelsächsischen Ländern spezialisierte Krankenpflegepersonen eine zentrale Rolle. Aus dem deutschsprachigen Raum liegen keine Daten zur Verwendung von PICCs und Midline-Kathetern vor. Ziel: Ziel war es, die Arten und Häufigkeiten von Komplikationen bei PICCs und Midline-Kathetern zu beschreiben, welche von spezialisierten Krankenpflegepersonen in einem Südtiroler Bezirkskrankenhaus angelegt wurden. Methoden: Es wurde eine retrospektive Kohortenstudie im Rahmen eines Implementierungsprojekts für die im Zeitraum 2013 bis 2015 in einer chirurgischen Abteilung angelegten PICCs und Midline-Katheter durchgeführt. Ergebnisse: Es wurden die Daten von insgesamt 900 Kathetern (421 Midline-Katheter und 479 PICCs) bei insgesamt 686 erwachsenen Patientinnen und Patienten (404 Frauen, 282 Männer) analysiert. Die kumulative Inzidenz lag bei 29,2 % Komplikationen für Midline-Katheter (Inzidenzdichte: 13 Komplikationen / 1000 Kathetertage) bzw. 16,0 % für PICCs (Inzidenzdichte: 3 Komplikationen / 1000 Kathetertage). Die häufigste Komplikation war die Selbstentfernung der Katheter (PICCs: 6,7 %; Midline-Katheter: 15,7 %). Weniger häufig kamen mechanische Komplikationen, Okklusionen, Infektionen und Thrombosen vor. Schlussfolgerungen: Die Komplikationsarten und -häufigkeiten für PICCs und Midline-Katheter lagen im Rahmen der internationalen Literatur. Spezialisierte Krankenpflegepersonen könnten auch im deutschsprachigen Raum erweiterte Rollen bei der Insertion und Pflege von PICCs und Midline-Kathetern entwickeln.


Types and frequencies of complications associated with midline catheters and PICCs in a South Tyrolean district hospital: a retrospective cohort study

Abstract.Background: Specialized registered nurses play a key role in the insertion and management of peripherally inserted central catheters (PICCs) and midline catheters in Anglo-Saxon countries. From the German-speaking area no data on the use of PICCs and midline catheters are available. Aim: The aim of this study was to describe the types and frequencies of complications of PICCs and midline catheters which were inserted by specialized registered nurses in a South Tyrolean district hospital. Methods: We performed a retrospective cohort study of PICCs and midline catheters inserted between 2013 and 2015 in one surgical unit in the district hospital Bruneck (South Tyrol / Italy). Results: Data from 900 catheters (421 midline catheters and 479 PICCs) inserted in 686 adult patients (404 women, 282 men) were analysed. The cumulative incidence was 29.2 % complications for midline catheters (incidence rate: 13 complications / 1000 catheter days) and 16.0 % for PICCs (incidence rate: 3 complications / 1000 catheter days). The most frequent complication was the removal of the catheter by the patients (PICCs: 6.7 %, midline catheters: 15.7 %). Other less frequent complications were mechanical complications, occlusions, infections and thromboses. Conclusions: This study in one district hospital revealed similar types and frequencies of complications as previous international studies. Specialized and clinically competent nurses in German-speaking countries could develop advanced roles in the insertion and management of PICCs and midline catheters.

Literatur

  • Bouzad, C.; Duron, S.; Bousquet, A.; Arnaudi, F. X.; Valbousquet, L.; Weber-Donat, G. … Potet, J. (2016). Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients. CardioVascular and Interventional Radiology, 39 (3), 385 − 393. First citation in articleGoogle Scholar

  • Chopra, V.; O’Horo, J. C.; Rogers, M. A.; Maki, D. G.; Safdar, N. (2013). The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis. Infection Control and Hospital Epidemiology, 34 (9), 908 − 918. First citation in articleGoogle Scholar

  • Chopra, V.; Flanders, S. A.; Saint, S.; Woller, S. C.; O’Grady, N. P.; Safdar, N. …Michigan Appropriateness Guide for Intravenouse Catheters, Panel (2015). The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND / UCLA Appropriateness Method. Annals of Internal Medicine, 163 (6 Suppl), 1 − 40. First citation in articleGoogle Scholar

  • Dougherty, L. (2007). Central Venous Access Devices: Care and Management. Oxford: Blackwell Publishing Ltd (trad.it. Cateteri venosi centrali: gestione e assistenza alla persona). Milano: McGraw-Hill. First citation in articleGoogle Scholar

  • Feast, A. R.; White, N.; Lord, K.; Kupeli, N.; Vickerstaff, V.; Sampson, E. L. (2018). Pain and delirium in people with dementia in the acute general hospital setting. Age and Ageing. doi: 10.1093/ageing/afy112. First citation in articleGoogle Scholar

  • Griffiths, V. (2007). Midline Catheters: Indications, complications and maintenances. Nursing Standard, 22 (11), 48 − 57. First citation in articleGoogle Scholar

  • Grau, D.; Clarivet, B.; Lotthe, A.; Bommart, S.; Parer, S. (2017). Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study. Antimicrobial Resistance & Infection Control, 6 (1), 18. First citation in articleGoogle Scholar

  • Lattarulo, P. (2014). Evidence based nursing e sviluppo di competenze. www.ipasvitaranto.com/pdf/IPASVI_Aprile%202014.pdf[06.08.2017]. First citation in articleGoogle Scholar

  • Loveday, H. P.; Wilson, J. A.; Pratt, R. J.; Golsorkhi, M.; Tingle, A.; Bak, A. … Wilcox, M. (2014). EPIC3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, 86 (Suppl 1), 1 − 70. First citation in articleGoogle Scholar

  • Maki, D. G.; Kluger, D. M.; Crnich, C. J. (2006). The risk of bloodstream infection in adults with different intravascular devices: A systematic review of 200 published prospective studies. Mayo Clinic Proceedings, 81 (9), 1159 − 1171. First citation in articleGoogle Scholar

  • O’Grady, N. P.; Alexander, M.; Burns, L. A.; Dellinger, E. P.; Garland, J.; Heard, SO. … the Healthcare Infection Control Practices Advisory Committee (HICPAC) (2011). Guidlines for prevention of intervascular catheter-related infections. Clinical Infectious Diseases, 52 (9), e162 − e193. First citation in articleGoogle Scholar

  • Paras-Bravo, P.; Paz-Zulueta, M.; Sarabia-Lavin, R.; Jose Amo-Setien, F.; Herrero-Montes, M.; Olavarria-Beivide, E. … Antolin-Juarez, F. M. (2016). Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study. PLOS ONE, 11 (9), 1 − 12. First citation in articleGoogle Scholar

  • Pittiruti, M.; Hamilton, H.; Biffi, R.; MacFie, J.; Pertkiewicz, M. (2009). ESPEN Guidelines on Parenteral Nutrition: Central Venous Catheters (access, care, diagnosis and therapy of complications). Clinical Nutrition, 28, 365 – 377. First citation in articleGoogle Scholar

  • Pittiruti, M.; Scoppettuolo, G. (2016). Manuale GAVeCeLT di PICC e di MIDLINE: Indicazioni, impianto, gestione. Milano: Edra S.p.A. First citation in articleGoogle Scholar

  • Pratt, R. J.; Pellowe, C. M.; Wilson, J. A.; Loveday, H. P.; Harper, P: J.; Jones, S. R. L. J. … Wilcox, M.H. (2007). EPIC2: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. Journal of Hospital Infection, 1 (6), 1 − 64. First citation in articleGoogle Scholar

  • Seckold, T.; Walker, S.; Dwyer, T. (2015). A comparison of silicone and polyurethane PICC lines and postinsertion complication rates: a systematic review. The Journal of Vascular Access, 16 (3), 167 − 177. First citation in articleGoogle Scholar

  • Sharp, R.; Esterman, A.; McCutcheon, H.; Hearse, N.; Cummings, M. (2014). The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective observational study. International Journal of Nursing Studies, 51 (5), 694 − 702. First citation in articleGoogle Scholar

  • Xu, T.; Kingsley, L.; DiNucci, S.; Messer, G.; Jeong, J. H.; Morgan, B. … Yassin, M. H. (2016). Safety and utilization of peripherally inserted central catheters versus midline catheters at a large academic medical center. American Journal of Infection Control, 44 (12), 1458 − 1461. First citation in articleGoogle Scholar

  • Yassin, M. H. (2017). Safety and use of peripherally inserted central catheters versus midline catheters at a large academic medical center. American Journal of Infection Control, 45 (4), 461. First citation in articleGoogle Scholar