[size=20px]Compared to centrally inserted venous catheters, peripheral inserted central catheters (PICCs) are associated with a higher rate of

 

a catheter patency.

 

b catheter fracture.

 

c central line associated blood stream infection (CLABSI).

 

d deep venous thrombosis.

 

e pulmonary embolism.[/size]

A

D

D

Correct answer

D deep venous thrombosis.

 

In large meta-analyses consisting of mostly adult patients, the comparisons of peripheral inserted central catheters (PICCs) versus centrally inserted venous catheters (CVCs) have failed to show differences in infection rate, rate of occlusion or displacement. The PICCs are most commonly used in the oncology population and an increased incidence of deep venous thrombosis (DVT) has been found in comparison to CVCs. Whether this is an artifact of selection bias or a real phenomenon is unclear. A 2013 meta-analysis from the Lancet identified an increased risk of DVT associated with PICC lines but no increase in pulmonary embolism. The increase in DVTs was attributed to the smaller size of the veins used for PICC lines with a relatively higher ratio of catheter to vein diameter. Intimal injury from frequent arm movements may play a role as well. The incidence of CLABSI is around 1.5 per 1,000 catheter days in pediatric PICC lines and no significant difference in CLABSI rates between PICC and CVC lines has been identified. Mechanical complications may be slightly increased in the smaller PICC lines.