Efficacy and Safety of Peripherally Inserted Central Venous Catheters
Peripherally Inserted Central Venous Catheter: Efficacy and Safety
Central venous access is critical for administering intravenous medications, parenteral nutrition, and fluid therapy in intensive care units (ICUs). Peripherally inserted central catheters (PICCs) provide an alternative to traditional centrally placed catheters, but they can be associated with complications such as blood clots (thrombosis), catheter-related infections, and mechanical blockages. The primary purpose of this study is to assess the procedural efficacy, functional lifespan, and complication rates of ultrasound-guided PICCs in critically ill adult patients.
In this prospective observational study, 60 adult ICU patients who require central venous access for at least 5 to 7 days will undergo bedside PICC placement by radiology staff using real-time ultrasound guidance and the modified Seldinger technique. Proper positioning of the catheter tip will be verified by a portable chest radiograph immediately after insertion.
Participants will be monitored daily while the catheter remains in place until line removal, ICU discharge, or death. Surveillance includes daily clinical site inspections, structured laboratory assessments, and scheduled compression Doppler ultrasound scans to check for blood clots in the cannulated arm. If an infection or blockage is suspected, appropriate blood cultures and diagnostic work-ups will be conducted. The gathered data will determine the insertion success rate, functional patency rate, and the overall incidence of complications per 1,000 catheter-days to establish evidence-based guidelines for vascular access in critical care.
研究概览
研究类型
注册 (估计的)
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
Adult critically ill patients aged 18 years or older admitted to the Intensive Care Unit (ICU) at Assiut University Hospital who require central venous access via a peripherally inserted central catheter (PICC) for clinical indications such as difficult peripheral venous access, administration of parenteral nutrition, prolonged intravenous antibiotic therapy (≥5 days), infusion of vesicant or vasoactive medications, or frequent blood sampling, with an anticipated need for central venous access or ICU stay of at least 5 to 7 days.
描述
Inclusion Criteria:
- Adult patients aged ≥ 18 years admitted to the Intensive Care Unit (ICU)
- Clinical requirement for central venous access via a peripherally inserted central catheter (PICC) (e.g., difficult peripheral venous access, parenteral nutrition, prolonged intravenous antibiotic therapy ≥ 5 days, or infusion of vesicant/vasoactive medications)
- Anticipated need for central venous access or ICU stay of at least 5 to 7 days
- Patient or legal representative willing and able to provide written informed consent
Exclusion Criteria:
- Age below 18 years
- Known hypersensitivity or allergy to catheter material (polyurethane or silicone)
- Local skin infection, cellulitis, or active thrombosis at the intended insertion site
- Documented ipsilateral upper-extremity or superior vena cava venous obstruction/stenosis precluding catheter passage
- Presence of an arteriovenous fistula or graft in the intended limb
- Severe, uncorrectable coagulopathy considered an absolute contraindication to catheter insertion
- Refusal of patient or legal guardian to provide informed consent
学习计划
研究是如何设计的？
设计细节
- 观测模型：COHORT
- 时间观点：PROSPECTIVE
队列和干预
团体/队列 |
|---|
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Critically Ill Patients Receiving PICC
Adult patients (aged 18 years or older) admitted to the intensive care unit requiring central venous access for at least 5 to 7 days for indications such as difficult peripheral access, parenteral nutrition, prolonged intravenous antibiotic therapy, or vasoactive infusions. All enrolled participants undergo bedside ultrasound-guided peripherally inserted central catheter (PICC) placement performed by the Radiology Department using the modified Seldinger technique, with tip position confirmed by post-procedure chest radiograph. Patients are followed daily throughout the catheter dwell period until line removal, ICU discharge, or death to evaluate insertion success, functional patency, and procedural complications including catheter-related bloodstream infections, upper-extremity deep vein thrombosis, and mechanical failures. |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Number of Participants With at Least One PICC-Related Complication
大体时间：Up to 30 days
|
Number of patients who experience at least one PICC-related complication (including catheter occlusion, accidental dislodgement, catheter-related bloodstream infection confirmed per CDC/NHSN criteria, or catheter-related venous thrombosis confirmed by Doppler ultrasound) during the catheter dwell period. |
Up to 30 days
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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