{"id":4798,"date":"2022-11-21T00:00:47","date_gmt":"2022-11-21T00:00:47","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=4798"},"modified":"2024-01-22T12:14:28","modified_gmt":"2024-01-22T10:14:28","slug":"cvcs-or-picc-lines-for-tpn","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/scientific-publications\/cvcs-or-picc-lines-for-tpn\/","title":{"rendered":"CVCs or PICC lines for TPN?"},"content":{"rendered":"

Peripherally inserted central catheters (PICCs) have been widely used as an alternative to central venous catheters (CVCs), especially for parental nutrition<\/span>1<\/span><\/sup>. The main advantages of PICCs are that they can be placed by trained nurses and without surgical intervention<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span>Because of the lack of economic evaluations on PICCs used for in-hospital total parenteral nutrition (TPN), the authors\u2019 objective was to compare the cost-effectiveness of PICCs inserted by a vascular-access team (VAT) with CVCs<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

Comas M, Domingo L, Jansana A, et al. Cost-effectiveness Analysis of Peripherally Inserted Central Catheters Versus Central Venous Catheters for in-Hospital Parenteral Nutrition. J Patient Saf. 2022. doi: <\/span><\/i>10.1097\/PTS.0000000000001028<\/span><\/i><\/a>\u00a0<\/span><\/p>\n

Methods<\/h2>\n

A cost-effectiveness analysis was carried out from January 2018 to December 2019 on observational data from electronic medical records<\/span>1<\/span><\/sup>. A total of 267 patients inserted with 292 PICCs by the VAT were included<\/span>1<\/span><\/sup>. A total of 217 patients with 233 CVCs were also included<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span>All included patients were adults who received TPN at the Hospital del Mar in Barcelona, Spain<\/span>1<\/span><\/sup>. They were also administered other treatments including antibiotic therapy and chemotherapy<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

The authors recorded the cost of catheter insertion, maintenance, removal and complications<\/span>1<\/span><\/sup>. Complications were classified into these five categories<\/span>1<\/span><\/sup>:\u00a0<\/span>\u00a0<\/span><\/p>\n

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  1. Bacteraemia<\/span>\u00a0<\/span><\/li>\n
  2. Deep-vein thrombosis<\/span>\u00a0<\/span><\/li>\n
  3. Suspected infection<\/span>\u00a0<\/span><\/li>\n
  4. Self-removal<\/span>\u00a0<\/span><\/li>\n
  5. Other complications<\/span>\u00a0<\/span><\/li>\n<\/ol>\n

    The main outcome measure was the incidence of catheter-associated bacteraemia per 1,000 catheter days<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

    More on this topic: <\/span><\/b>Cat\u00e9ter PICC o cat\u00e9ter con reservorio: \u00bfcu\u00e1l es mejor para los pacientes con c\u00e1ncer?<\/a><\/p>\n

    Results<\/h2>\n

    Complication rates per 1,000 days of catheter use for bacteraemia were 1.15% for PICCs and 2.44% for CVCs <\/span>(<\/span>P <\/span><\/i>= 0.278)<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span>When compared with CVCs for in-hospital TPN, PICCs inserted by a VAT cost \u20ac560 less per patient<\/span>1<\/span><\/sup>. These cost savings were due to lower insertion costs as well as a lower<\/span> incidence of bacteraemia with PICCs<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

    Conclusion<\/h2>\n

    This study demonstrates that when PICC lines for TPN are placed by the expert nurses of a VAT they may lead to lower costs and a lower incidence of bacteraemia when compared with CVCs<\/span>1<\/span><\/sup>.<\/span>\u00a0<\/span><\/p>\n

    More on this topic: <\/span><\/b>NIVAS white paper: The benefits of a vascular access team<\/span><\/a>\u00a0<\/span><\/p>\n

    Read more scientific publications<\/span><\/a><\/div>\n
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