Download PDF
CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2021; 04(01): e29-e33
DOI: 10.1055/s-0041-1728747
Original Article

Peripherally Inserted Central Venous Catheters Provide Safe and Easy Central Venous Access in Patients with Head and Neck Cancer

Ryosuke Sato
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Takumi Kumai
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Ryusuke Hayashi
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Hiroki Komatsuda
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Kan Kishibe
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Miki Takahara
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Akihiro Katada
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Tatsuya Hayashi
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
,
Yasuaki Harabuchi
1   Department of Otolaryngology–Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
› Further Information
   Permissions and Reprints

Abstract

Purpose The use of peripherally inserted central venous catheters (PICCs) has increased recently; several reports have revealed that they can be easily and safely used in patients with various diseases. However, there are few reports on the use of PICCs in patients with head and neck cancer. This study was aimed at evaluating the safety and feasibility of use of PICCs in patients with head and neck cancer.

Materials and Methods We retrospectively analyzed the date of 118 PICC insertions in 85 patients with head and neck cancer from January 2014 to December 2017. The PICCs have been placed under ultrasound guidance in all cases.

Results The PICC puncture success rate was 95.2%. Catheter-related bloodstream infection occurred in four cases. The most common complication necessitating PICC removal was suspected catheter-related bloodstream infection (24 cases). All cases with confirmed and suspected catheter-related bloodstream infection improved with administration of antimicrobial agents. Phlebitis occurred in five cases, in all of whom the PICC placement had been made via an antecubital vein; the condition improved without treatment in all five cases. Deep vein thrombosis occurred in two cases, both of which improved with oral anticoagulant therapy.

Conclusion This study demonstrated that the complications associated with ultrasound-guided PICC insertion are manageable, and improve with conservative treatment in the majority of cases. Therefore, use of PICCs may be considered for easy and safe central venous access in patients with head and neck cancer, because the insertion success rate was acceptable.

Keywords

central venous catheters - peripheral catheterization - catheter-related infections - head and neck cancer


Publication History

Received: 22 June 2020

Accepted: 09 October 2020

Article published online:
21 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Sakai T, Kohda K, Konuma Y. et al. A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. Int J Hematol 2014; 100 (06) 592-598
    CrossrefPubMedGoogle Scholar
  • 2 Gunst M, Matsushima K, Vanek S, Gunst R, Shafi S, Frankel H. Peripherally inserted central catheters may lower the incidence of catheter-related blood stream infections in patients in surgical intensive care units. Surg Infect (Larchmt) 2011; 12 (04) 279-282
    CrossrefPubMedGoogle Scholar
  • 3 Bellesi S, Chiusolo P, De Pascale G. et al. Peripherally inserted central catheters (PICCs) in the management of oncohematological patients submitted to autologous stem cell transplantation. Support Care Cancer 2013; 21 (02) 531-535
    CrossrefPubMedGoogle Scholar
  • 4 Mermel LA, Allon M, Bouza E. et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49 (01) 1-45
    CrossrefPubMedGoogle Scholar
  • 5 Frykholm P, Pikwer A, Hammarskjöld F. et al; Swedish Society of Anaesthesiology and Intensive Care Medicine. Clinical guidelines on central venous catheterisation. Acta Anaesthesiol Scand 2014; 58 (05) 508-524
    CrossrefPubMedGoogle Scholar
  • 6 Parienti JJ, Mongardon N, Mégarbane B. et al; 3SITES Study Group. Intravascular complications of central venous catheterization by insertion site. N Engl J Med 2015; 373 (13) 1220-1229
    CrossrefPubMedGoogle Scholar
  • 7 O'Grady NP, Alexander M, Burns LA. et al; Healthcare Infection Control Practices Advisory Committee (HICPAC) (Appendix 1). Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52 (09) 1087-1099
    CrossrefPubMedGoogle Scholar
  • 8 Wang Q, Wang N, Sun Y. Clinical effect of peripherally inserted central catheters based on modified Seldinger technique under guidance of vascular ultrasound. Pak J Med Sci 2016; 32 (05) 1179-1183
    CrossrefPubMedGoogle Scholar
  • 9 Elen Hughes MM. PICC-related thrombosis: pathophysiology, incidence, morbidity and the effect of ultrasound-guided placement technique on occurrence in cancer patients. JAVA 2011; 16: 8-18
    CrossrefPubMedGoogle Scholar
  • 10 Gong P, Huang XE, Chen CY, Liu JH, Meng AF, Feng JF. Comparison of complications of peripherally inserted central catheters with ultrasound guidance or conventional methods in cancer patients. Asian Pac J Cancer Prev 2012; 13 (05) 1873-1875
    CrossrefPubMedGoogle Scholar
  • 11 McMahon DD. Evaluating new technology to improve patient outcomes: a quality improvement approach. J Infus Nurs 2002; 25 (04) 250-255
    CrossrefPubMedGoogle Scholar
  • 12 Harter C, Ostendorf T, Bach A, Egerer G, Goldschmidt H, Ho AD. Peripherally inserted central venous catheters for autologous blood progenitor cell transplantation in patients with haematological malignancies. Support Care Cancer 2003; 11 (12) 790-794
    CrossrefPubMedGoogle Scholar
  • 13 Roth RR, James WD. Microbial ecology of the skin. Annu Rev Microbiol 1988; 42: 441-464
    CrossrefPubMedGoogle Scholar
  • 14 Chopra V, Anand S, Hickner A. et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet 2013; 382 (9889): 311-325
    CrossrefPubMedGoogle Scholar
  • 15 Nifong TP, McDevitt TJ. The effect of catheter to vein ratio on blood flow rates in a simulated model of peripherally inserted central venous catheters. Chest 2011; 140 (01) 48-53
    CrossrefPubMedGoogle Scholar
  • 16 Hashimoto Y, Fukuta T, Maruyama J, Omura H, Tanaka T. Experience of peripherally inserted central venous catheter in patients with hematologic diseases. Intern Med 2017; 56 (04) 389-393
    CrossrefPubMedGoogle Scholar
  • 17 Allen AW, Megargell JL, Brown DB. et al. Venous thrombosis associated with the placement of peripherally inserted central catheters. J Vasc Interv Radiol 2000; 11 (10) 1309-1314
    CrossrefPubMedGoogle Scholar
  • 18 Merrell SW, Peatross BG, Grossman MD, Sullivan JJ, Harker WG. Peripherally inserted central venous catheters: low-risk alternatives for ongoing venous access. West J Med 1994; 160 (01) 25-30
    PubMedGoogle Scholar