Kalma Benjamin, van Zundert André
Department of Intensive Care, Royal Brisbane and Women's Hospital, Brisbane, QLD 4006, Australia.
Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD 4006, Australia.
Healthcare (Basel). 2025 Aug 14;13(16):1993. doi: 10.3390/healthcare13161993.
Peripherally inserted central catheters (PICCs) are becoming an increasingly utilised alternative to traditional central venous access devices. Their uptake, particularly among oncology patients, is due to their growing ease of access, suitability for medium-term use and perceived safety profile. However, PICCs can be a source of severe and life-threatening complications such as central line-associated bloodstream infection (CLABSI), deep vein thrombosis (DVT), pulmonary embolism (PE), malpositioning, dislodgement, and occlusion.
This narrative was constructed from a literature review of the PubMed database, utilising MESH terms for peripherally inserted central catheters, percutaneous central catheters, PICC, and complications. Randomised controlled trials, systematic reviews, and meta-analyses published between 2015 and 2025 were included. Additional articles were obtained through targeted PubMed searches or from references within previous articles.
Major periprocedural complications were seen in 1.1% of PICC insertions, CLABSI in 1.4-1.9%, venous thrombosis embolism (including PE) in 2.3-5.9%, and malpositioning in 7.87%. The overall PICC complication incidence was 9.5-38.6%, which is greater than that of centrally inserted central venous access. A higher BMI, diabetes mellitus, chronic renal failure, and malignancy were the most significant predictive factors for PICC-associated complications.
PICC complications are common, occurring more frequently than other forms of central venous access, and may lead to significant morbidity and mortality. Appropriate assessment of patient risk factors and optimisation strategies may reduce complication rates.
外周静脉穿刺中心静脉导管（PICC）正逐渐成为传统中心静脉通路装置越来越常用的替代方案。其被广泛采用，尤其是在肿瘤患者中，这归因于其越来越容易操作、适合中期使用以及公认的安全性。然而，PICC可能是严重且危及生命的并发症的来源，如中心静脉导管相关血流感染（CLABSI）、深静脉血栓形成（DVT）、肺栓塞（PE）、位置不当、移位和堵塞。
本叙述性综述基于对PubMed数据库的文献检索构建，使用了外周静脉穿刺中心静脉导管、经皮中心静脉导管、PICC和并发症的医学主题词（MESH）。纳入了2015年至2025年间发表的随机对照试验、系统评价和荟萃分析。通过针对性的PubMed检索或从先前文章的参考文献中获取了其他文章。
在PICC置管中，1.1%出现主要围手术期并发症，1.4 - 1.9%出现CLABSI，2.3 - 5.9%出现静脉血栓栓塞（包括PE），7.87%出现位置不当。PICC总体并发症发生率为9.5 - 38.6%，高于中心静脉穿刺中心静脉通路。较高的体重指数、糖尿病、慢性肾衰竭和恶性肿瘤是PICC相关并发症最显著的预测因素。
PICC并发症很常见，比其他形式的中心静脉通路更频繁发生，可能导致显著的发病率和死亡率。对患者风险因素进行适当评估和优化策略可能会降低并发症发生率。
