{"id":6094,"date":"2023-12-21T15:10:35","date_gmt":"2023-12-21T13:10:35","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=6094"},"modified":"2023-12-21T16:03:23","modified_gmt":"2023-12-21T14:03:23","slug":"piccs-in-intensive-care-units-new-spanish-guidelines-fill-a-gap","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/news-innovation\/piccs-in-intensive-care-units-new-spanish-guidelines-fill-a-gap\/","title":{"rendered":"PICCs in intensive care units: new Spanish guidelines fill a gap"},"content":{"rendered":"<p><span data-contrast=\"auto\">When and how should peripherally inserted central catheters (PICCs) be used in intensive care units (ICUs)?<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">At the end of 2022, the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) published:<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">Gu\u00eda de pr\u00e1ctica cl\u00ednica sobre el uso de cat\u00e9teres venosos centrales de inserci\u00f3n perif\u00e9rica (PICC) en el paciente cr\u00edtico <\/span><\/i><span data-contrast=\"auto\">(Clinical practice guidelines on the use of peripherally inserted central catheters (PICCs) in critically ill patients)<\/span><sup><span data-contrast=\"auto\">1<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<div class=\"su-button-center\"><a href=\"https:\/\/semicyuc.org\/wp-content\/uploads\/2022\/12\/guia-picc.pdf\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#2D89EF;border-color:#246ec0;border-radius:6px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#FFFFFF;padding:0px 18px;font-size:14px;line-height:28px;border-color:#6cadf4;border-radius:6px;text-shadow:none\"> Download guidelines on PICCs in intensive care units<\/span><\/a><\/div>\n<p>&nbsp;<\/p>\n<p><span data-contrast=\"auto\">BD IV News interviewed Noem\u00ed Cort\u00e9s Rey, a member of the working group that created these practice guidelines.<\/span> <span data-contrast=\"auto\">Ms. Cort\u00e9s Rey is a nurse training supervisor at University Hospital of A Coru\u00f1a in Spain.\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">She used to work in the ICU and understands the challenges healthcare professionals (HCPs) face when selecting and maintaining vascular access devices (VADs) in these settings.\u00a0<\/span><span data-contrast=\"auto\">With her colleagues, she implemented a vascular access team (VAT) in the ICU.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">More on this topic: <\/span><\/b><a href=\"https:\/\/eu.bd.com\/iv-news\/news-innovation\/the-push-to-build-vascular-access-teams-in-ireland\/\"><span data-contrast=\"none\">The push to build vascular access teams in Ireland<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h2>1. What was the situation in Spanish intensive care units before 2022?<\/h2>\n<p><span data-contrast=\"auto\">Ms Cort\u00e9s Rey said that before the guidelines were developed, Spanish nurses usually followed the U.S. <\/span><i><span data-contrast=\"auto\">Infusion Therapy Standards of Practice<\/span><\/i><span data-contrast=\"auto\"> from the Infusion Nurses Society.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><span data-contrast=\"auto\">But she added that these didn\u2019t completely cover vascular access management (VAM) in critical care.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<h2>2. Why were these intensive care unit practice guidelines created?<\/h2>\n<p><span data-contrast=\"auto\">Ms Cort\u00e9s Rey explained that SEMICYUC launched a project to come up with evidence-based guidelines for PICCs in ICUs. The use of PICCs has increased exponentially over the last few years on general wards and especially in ICUs.<\/span><sup><span data-contrast=\"auto\">2<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">However, PICCs have multiple indications, but it was not very clear how to apply them in critical care patients according to Ms Cort\u00e9s Rey.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">She said the aim of SEMICYUC was to create a useful tool to clarify these indications, help Spanish ICU HCPs in VAM, prevent IV complications and reduce adverse events.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h2>3. What advantages do PICCs in intensive care units have over other acute central venous catheters?<\/h2>\n<p><span data-contrast=\"auto\">She pointed out the main advantage of PICCs: They\u2019re useful for patients requiring medium- to long-term IV therapy. She added they can be inserted by trained doctors and nurses (mainly by the latter).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Because nurses work at the patients\u2019 bedside 24\/7, PICCs can be usCashed whenever they\u2019re needed explained Ms Cort\u00e9s Rey. She thinks this type of VAD can be useful for certain patient populations, including patients with obesity, thoracic trauma, stoma or coagulation disorders.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">She doesn\u2019t recommend using PICCs in emergency situations as the first option when a central line is needed. In this case, centrally inserted central catheters (CICCs) are the first choice due to the need for immediate insertion according to her.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h2>4. How have these practice guidelines been received by critical care nurses and doctors?<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/h2>\n<p><span data-contrast=\"auto\">When Ms Cort\u00e9s Rey started to review the medical literature, she couldn&#8217;t find many research papers focusing on the use of PICCs in critical care. Thanks to these new guidelines, nurses and doctors from ICUs are quickly gaining new knowledge and expertise.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<h2>5. What has been the impact of these practice guidelines on patient care?<\/h2>\n<p><span data-contrast=\"auto\">She felt like she and her colleagues had reached an inflection point when they started implementing a VAT and using PICCs in critical care.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">She expanded on this by adding that some of their patients, like those undergoing lung or liver transplant stay in the ICU for a long time. They may need 3\u20135 central lines at the same time. These patients usually start with a CICC (in the jugular vein). Within 10\u201314 days, nurses insert a PICC and remove the CICC. Some patients keep both.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Using these guidelines when implementing PICCs in critical care allows HCPs to standardise practice through updated protocols that help reduce variability.<\/span><sup><span data-contrast=\"auto\">2<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><span data-contrast=\"auto\">By following these new guidelines, Ms Cort\u00e9s Rey shared that HCPs in her ICU have dramatically reduced rates of thrombosis and catheter-related bloodstream infections (CRBSIs) in their patients.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">More on this topic: <\/span><\/b><a href=\"https:\/\/eu.bd.com\/iv-news\/events-training\/how-to-identify-and-reduce-the-risk-of-catheter-related-thrombosis\/\"><span data-contrast=\"none\">How to identify and reduce the risk of catheter-related thrombosis<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The SEMICYUC concludes, \u201cWe are very satisfied with the work done and hope that these guidelines will enable coordinated, safe and efficient decision making on the use of PICCs by professionals and improve the quality of care, while increasing patient and professional satisfaction.\u201d<\/span><sup><span data-contrast=\"auto\">2<\/span><\/sup><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When and how should peripherally inserted central catheters (PICCs) be used in intensive care units (ICUs)?\u00a0At the end of 2022,&#8230;<\/p>\n","protected":false},"author":8,"featured_media":6776,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6094","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news-innovation","speciality-critical-care-emergency-care","speciality-vascular-access","contenttype-interview","target-doctor","target-nursing"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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