Peripherally inserted central catheter

Encyclopedia : P : PE : PER : Peripherally inserted central catheter

Correct position of PICC line on chest x-ray

A peripherally inserted central catheter (PICC or PIC line) is a form of intravenous access that can be used for a prolonged period of time, e.g. for long chemotherapy regimens, extended antibiotic therapy or total parenteral nutrition. First described in 1975Hoshal VL. Total intravenous nutrition with peripherally inserted silicone elastomer central venous catheters. Arch Surg 1975;43:1937-43. PMID 805577. it is an alternative to subclavian lines, internal jugular lines or femoral lines which have higher rates of infection. Subclavian and internal jugular line placements may result in pneumothorax (punctured lung).

A PICC is inserted in a peripheral vein, such as the cephalic vein, basilic vein, or brachial vein and then advanced through increasingly larger veins, toward the heart until the tip rests in the distal superior vena cava or cavo-atrial junction.

PICCs are usually inserted by radiologists, radiology practitioner assistants, radiologist assistants, or certified registered nurses using ultrasound and X-rays to confirm their insertion and placement. Complications may include hemorrhage, thrombosis and infection. PIC lines generally will remain in place no longer than 30 days, although they may be placed for just a few days in patients requiring short courses of chemotherapy or biotherapy. Patients have survived with the same PICC in situ for several years without complication.

Certain types of PICCs have recently been approved by the FDA for use in power injection. These PICCs, often referred to as "POWER PICCs", are designed to withstand the high pressures associated with radiocontrast studies. These PICCs are commonly identified by their purple color.

Reference