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PICC Lines in
the ICU
Intravascular devices
(IVDs) are universally employed for treatment of patients
in the intensive care unit. Often multiple lines are
used for the administration of medications and intravenous
fluids. If peripheral veins are used for this purpose,
the catheters must to be changed very frequently. This
can often be difficult and at times venous access is
not possible because of blockage from repeated puncture
and inflammation, inability to palpate or visualize
vessels, or from physical conditions relating to the
underlying disease or illness. In these circumstances
a central venous catheter can prove vital as it may
be retained for long time periods and provide multiple
accessed via one line. But central lines have their
own complications, which can be serious such as a pneumothorax.
In these cases a peripherally inserted central catheter
(PICC) can prove most beneficial.
The use of peripherally
inserted central catheters in intensive care units (ICU)
for intermediate to long term venous access has increased
steadily and significantly over the past decade. In
addition to a significantly longer duration time, studies
have shown less incidences of venous inflammation and
subsequent blockages. But PICCs should not be expected
to replace existing methods of vascular access but,
rather, used to provide a safe and effective alternative.
Previously stated, PICCs
are generally used for the administration of medications
and intravenous fluids. However, they have other uses
as well. Patients treated in the ICU typically require
repeated blood sampling for laboratory evaluations such
as liver function, blood sugar, creatinine, to determine
responsiveness of current treatment and patient status.
Repeated puncturing to obtain blood samples may not
be possible or successful all the time and also is also
painful to already sick patients. A PICC may be utilized
to draw blood samples for various investigations and
thus reduce the number of pricks. Additionally, PICC
lines can be used to measure central venous pressure
(CVP) necessary for assessing patients with various
cardiovascular diseases and illnesses.
Although PICCs in the
ICU have many benefits, complications can occur. These
complications include like malposition, catheter clotting,
bleeding, mechanical phlebitis, arterial puncture and,
rarely, infections. Patients with a decrease in immunological
function along with other underlying illnesses further
increase the risk of PICC related infection.
However, many studies
done on PICCs in ICU have found that it is a safer and
effective alternative to conventional peripheral catheters
and central venous catheters, as well as having an exceptionally
high success rate in obtaining IV access. Additional
large scale studies would be beneficial to fully determine
if they should be the standard of care for regular use
in ICU.
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on this Website is for informational and educational
purposes only and is not a substitute for medical advice
or treatment for any medical conditions.
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