Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas12), School of Medicine, Universidad Complutense, Madrid, Spain.
Nursing Management, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (imas12), School of Medicine, Universidad Complutense, Madrid, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2020 Nov;38(9):425-430. doi: 10.1016/j.eimc.2020.01.005. Epub 2020 Feb 11.
Data concerning the use of peripherally inserted central catheters (PICC) for the administration of intravenous (IV) antimicrobials in the acute care setting is scarce.
We performed a single-center retrospective case-control study (1:1). Case subjects were defined as patients who received IV antimicrobial treatment through a PICC line placed and maintained by specifically trained nurses (PICC group). Control subjects were defined as patients who received antimicrobial therapy by a peripheral or a central venous catheter (CVC) (control group). Control subjects were matched by type of antimicrobial, causative microorganism of the infection that was being treated and duration of treatment. An event leading to undesired catheter removal (ELUCR) was defined as any circumstance which lead to the removal of the indwelling catheter other than the completion of the scheduled course of antimicrobial therapy.
The study included 50 patients in each group. The total follow-up time was 1376 catheter-days for the PICC group and 1362 catheter-days for the control group. We observed a significantly lower incidence of ELUCR in the PICC group (0.2 versus 7.7 events per 100 catheter-days; P<0.001). When the incidence of ELUCR was analyzed according to the duration of indwelling catheterisation for each type of catheter (divided into one-week intervals), differences between both groups were also significant (P-values≤0.001 for the first three weeks of treatment). During the second week of IV treatment, only one patient in the PICC group (2.1%) developed an ELUCR compared to 19 (38.8%) in the control group (P<0.001).
A PICC placed and maintained by a dedicated nursing team is an excellent alternative to peripheral venous catheters or CVCs for administrating antimicrobial therapy for both short and long periods of treatment.
关于在急性护理环境中使用外周静脉置入中心导管（PICC）来输注静脉（IV）抗菌药物的数据很少。
我们进行了一项单中心回顾性病例对照研究（1:1）。病例组定义为接受由专门培训的护士放置和维护的 PICC 导管输注 IV 抗菌药物治疗的患者（PICC 组）。对照组定义为接受外周或中心静脉导管（CVC）输注抗菌药物治疗的患者（对照组）。对照组通过抗菌药物类型、感染的病原体和治疗持续时间进行匹配。非计划拔管事件（ELUCR）定义为除完成预定的抗菌药物疗程之外导致留置导管被移除的任何情况。
每组各纳入 50 例患者。PICC 组的总随访时间为 1376 个导管日，对照组为 1362 个导管日。我们观察到 PICC 组的 ELUCR 发生率显著降低（每 100 个导管日的 0.2 与 7.7 例事件；P<0.001）。当根据每种导管的留置时间（分为一周间隔）分析 ELUCR 的发生率时，两组之间的差异也具有统计学意义（前 3 周治疗的 P 值均≤0.001）。在 IV 治疗的第 2 周，PICC 组仅有 1 例（2.1%）患者发生 ELUCR，而对照组有 19 例（38.8%）（P<0.001）。
由专门护理团队放置和维护的 PICC 是输注短期和长期抗菌药物治疗的外周静脉导管或 CVC 的极佳替代选择。
