Elsevier

Journal of Vascular Nursing

Volume 36, Issue 3, September 2018, Pages 149-156
Journal of Vascular Nursing

Article
A study of the use of peripherally inserted central catheters in cancer patients: A single-center experience

https://doi.org/10.1016/j.jvn.2018.05.001Get rights and content

Effective and reliable venous access is one of the cornerstones of modern medical therapy in oncology. The focus of this prospective observational research is to study the various indications of a peripherally inserted central catheter (PICC) in different solid and hematological malignancies and the various complications and outcomes in the pediatric and adult cancer patients. This study was conducted in a prospective observational study design and collected data of patients with a diagnosis of any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period. The PICC was inserted in 352 patients and most commonly used in hematological conditions (n = 295, 83.8%), followed by solid malignancies 57 (16.2%). In the hematological malignancy group, acute myeloid leukemia (48.01%) was the most common indication, and in the solid malignancies group, osteosarcoma (n = 9, 2.55%) was the most common indication for PICC insertion. PICCs were inserted most commonly in the left side of the venous system in 70.7% cases. The complications in the PICC study group included infections (12.5%), thrombosis (4.82%), catheter blockage (4.82%), arrhythmias (4%), premature catheter removal (3%), bleeding (2.55%), and pneumothorax (2.55%). The median days of the PICC use in situ were 152 days. To conclude from our study, PICCs are most commonly indicated in malignancies that are requiring long-term chemotherapy, such as hematological malignancy, especially acute myeloid leukemia, and solid malignancies, usually osteosarcoma, and these catheters are associated with complications such as infection, thrombosis, catheter blockage, arrhythmia, bleeding, and pneumothorax. The most disturbing aspect of the treatment of a cancer patient is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. From this study, we can infer that PICC lines can be used for various malignancies that require long-term chemotherapy.

Section snippets

Materials and methods

This is a prospective observational study, and in this study, we have collected data pertaining to PICC insertion in patients with a diagnosis of any type of cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, over a 2-year period (August 2013–2015). Patients of all age and sex, presenting to the Department of Medical and Pediatric Oncology and Hematology at the Gujarat Cancer Research Institute (GCRI) was included.

The data were collected from the department of

Results and observations

In this present prospective observational study, patients of all age and sex who are presenting to Department of Medical and Pediatric Oncology, at GCRI, a tertiary care oncology hospital in Ahmadabad, Gujarat, India, with a diagnosis of any cancer during a 2-year period (August 2013–2015) were included. The data were collected for the indications, complications, and outcomes of PICCs, in various malignancies, from the patients admitted in the department of medical and pediatric oncology, bone

Complications

The various complications with their incidence, method of confirmation, and treatment of the same are discussed in the following sections (Figure 2).

Discussion

The most disturbing aspect of treatment of a cancer patient is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. To overcome these problems of multiple painful venipunctures, peripherally inserted silicone catheters, implantable ports have been tried with varying success. The introduction of CVCs in the 1980s significantly improved the quality of life of oncology patients.9, 10, 11, 12

After an extensive search

Future perspective

This present study stand out to be one of the major prospective observational studies with large number of patients in a tertiary care oncology setup. Most of the data at present in Indian setup are retrospective in nature, and this study can be used as a reference for future prospective observational studies. The suggestions for future medical researchers include incorporation of quality of life measures, details of different infections, drug sensitivity, and advanced technological methods

Summary and conclusion

This prospective study presents comprehensive data from a large sample size with regard to the patterns of use, indications of use, and the associated complications of PICC in both solid and hematological malignancies. With regard to the patterns of use, the ratio of hematological to solid malignancy indications was 83.8%:16.2% for the PICC insertion. The study has also successfully documented the most common hematological and solid malignancy indications. The most common indication in the

Acknowledgments

The authors are thankful to the Department of Surgical Oncology and anesthesia staff of GCRI, Ahmedabad, for their constant support during the study tenure of this research work.

Authors' contribution: I.M. conceived and designed the experiment. I.M. and A.P. analyzed the data. I.M. and A.P. wrote the first draft of the article. I.M., A.P., M.S., A.A., P.K., and N.K. contributed to the writing of the article. M.S., A.A., P.K., and N.K. agreed with manuscript results and conclusions. I.M., M.S.,

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    Conflict of interest: The authors declare no conflicts of interest to disclose.

    Financial disclosure: There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs.

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