EFFECTIVENESS OF THE PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER IN ADULT AND PEDIATRIC PATIENTS

Author(s)

Dantas SR1, Fagnani R1, Lima TC1, Silva VA1, Azevedo MO1, Bueno GC1, Gadanhoto AP1, Oliveira AP2, Psaltikidis EM1, Carrara D3, Resende MR4
1Clinical Hospital of State University of Campinas, Campinas, Brazil, 2Faculty of Medical Sciences of State University of Campinas, Campinas, Brazil, 3Heart Institute - Medical School of the University of São Paulo, São Paulo, Brazil, 4Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil

OBJECTIVES::  This study aims to assess whether the use of the peripherally inserted central venous catheters (PICC) is more effective than the peripheral catheters and the centrally inserted central catheters to short permanence in adult and pediatric patients, for intravenous therapy greater than 14 days. METHODS::  The PICO tool was used: adult and pediatric patients (population); PICC (intervention); other short permanence catheters, either central or peripheral (comparator); local and systemic infection, length of use of the device, risks related to catheter placement and maintenance, costs and work process (outcomes). Nine electronic databases were searched (including PUBMED, Cochrane, Embase and Bireme) and manual search. The screening of studies, quality assessment, extraction and analysis were performed by two independent researchers. RESULTS::  935 studies were identified, and after the selection, seven were included: three systematic reviews (two with meta-analysis), three randomized controlled trials and one cohort study. Most studies were published in 2013 (71,4%) and made in the USA (57,1%). Five studies compared the PICC to central venous catheter and two studies compared the PICC to peripheral venous catheter. The most analyzed outcomes were thrombosis and local and systemic infections by five studies. The PICC had longer permanence and lower healthcare demand compared to other catheters. Only one study showed significant difference in systemic infection. There was no significant difference in local infection.The main risk related to the maintenance of the PICC is venous thrombosis with a significant difference in three of the five analyzed studies. About catheter placement, only the risk of malposition was higher. CONCLUSIONS:: The PICC has specific indications that differ from those of short permanence peripheral or central catheters, being a more effective option for adult and pediatric patients who require intravenous therapy longer than 14 days, continuous or intermittent, in hospitals, outpatient and home care.

Conference/Value in Health Info

2017-09, ISPOR Latin America 2017, Sao Paulo, Brazil

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PMD41

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Multiple Diseases

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