High rate of complications associated with peripherally inserted central venous catheters in patients with solid tumours

Abstract

Background : Peripherally inserted central catheters (PICC) have been used extensively as a cost‐effective and safe form of medium‐term intravascular access. There are only limited data about complications of PICC lines in oncology patients despite theoretical concerns about the higher risks of complications in these patients as a result of cancer itself and cancer therapy. Aims : To document the frequency and type of PICC complications in patients with solid tumours. Methods : All patients with solid tumours who were treated at Flinders Medical Centre, Adelaide, South Australia, Australia between January 2000 and March 2001 were included in a retrospective review of PICC complications. Results : Twenty‐seven PICC lines were inserted in 17 patients; 40.7% (11/27) of PICC lines developed complications requiring early removal of the PICC. Complications encountered were sepsis (systemic and cellulitis), thrombosis, blockage and leakage. Septic complications were found at a rate of 8/1000 PICC days or 25.7% (7/27) of PICC inserted. The median dwell time was 20 days. The mean time for a complication to occur was 27.5 days. Conclusions : The present study demonstrates a high rate of complications, which is higher than the complication rates reported in studies of non‐oncology patients. PICC lines should be used with caution in patients with solid tumours. Prospective studies of the factors influencing the incidence of complications might be warranted. (Intern Med J 2004; 34: 234−238)