The peripherally inserted central catheter (PICC): A prospective study of its natural history after cubital fossa insertion

A prospective cohort study was undertaken to describe the natural history of the cubital fossa peripherally inserted central catheter (PICC), determine which factors influenced the hazard of complication and develop a standard methodology,for evaluation of a PICC service. A total of 4349 patient days of PICC observation were analysed using survival analysis techniques. The median time to PICC removal for a complication was 60 days. The most common complications were phlebitis, malposition and tip migration. Complications usually occurred during the first week. There it-as only one episode of line-related sepsis. Size 3 French gauge catheters had a complication rate of 7 3 per 1000 line days compared to 14.2 for 4 French catheters (hazard rate 1.26 905, CI 1.02 to 1.55). PICCs requiring two or more attempts at insertion were more likely to develop complications than those inserted at the first attempt: 20 per 1000 line days vs 10.5 but the confidence intervals were wide (hazard rate 1.91, 90% CI 0.90 to 4.05). Operator (amongst the four experienced operators who inserted all PICCs), ann of placement, or medial or lateral placement in the cubital fossa did not influence PICC survival.