Complications associated with peripherally inserted central catheters and Hickman™ in patients with advanced pulmonary hypertension treated with intravenous prostanoids - 08/12/21
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Abstract |
Background |
Epoprostenol requires continuous infusion and may lead to catheter-related complications. Evidence regarding the comparison between peripherally inserted central catheters (PICC) or tunneled central catheters in Pulmonary Hypertension (PH) is scarce. We sought to study the incidence of mechanical and infectious complications associated with PICC and Hickman catheters in patients with PH under epoprostenol treatment.
Methods |
This is a single-center retrospective study of patients with PH who received continuous treatment with intravenous epoprostenol for at least 24 h between January 2010 and July 2020. Mechanical and infectious complications were analyzed according to the catheter type: PICC and Hickman. The incidence of catheter-related complications was calculated per 1000 exposure-days of risk.
Results |
175 catheters were implanted in 109 patients, of which 100 (57.1%) were Hickman and 75 (42.9%) were PICC. After a median follow-up of 334 [130–798] days, there were no differences in the rates of local (0.22 vs 0.21; p = 0.904) or blood-stream infections (0.13 vs 0.21; p = 0.405). Mechanical complications were more frequent in the PICC group (0.98 vs 0.23 p=<0.001), including venous thrombosis (0.16 vs 0.00 p = 0.003) and catheter occlusion (0.66 vs 0.04 p=<0.001). These complications were associated with a greater need for hospitalization (1.48 vs 0.50; p=<0.001), without differences in mortality during follow-up (0.33 vs 0.21; p = 0.288).
Conclusion |
In patients with PH treated with intravenous epoprostenol, both Hickman and PICC catheters were associated with high rate of complications. Although there were no differences in the frequency of infectious-related complications, PICC was associated with a higher frequency of catheter occlusion and deep venous thrombosis.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Hickman catheter and PICC are associated with high incidence of infectious and mechanical complications. |
• | The incidence of infectious complications were comparable between Hickman carriers and PICC. |
• | Hickman catheters are associated with lower incidence of mechanical complications compared to PICC. |
• | The DVT and occlusion were more frequent in CTEPH group and in patients treated with PICC. |
Keywords : Pulmonary hypertension, Peripherally inserted central catheter, Hickman catheter, Chronic thromboembolic pulmonary hypertension, Catheter-related complications
Abbreviations : BSI, CHD, CTEPH, DVT, PH, PICC
Plan
Vol 189
Article 106649- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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