PICC line

[manojpotdar]

(1) What dextrosity we can use through PICC catheter? We are using 25% if catheter is at the junction of SVC/IVC and rt atrium, 20% if in deep vein and 12.5 % if in peripheral veins.

(2) For how many days we can keep the PICC lines?

(3) Is there any need for routine blood culture (PICC) to be sent ?

[Francesco Cardona]

1) We use up to 33% Dextrose (it is the recommendation of the company) and will lower % if the PICC line lies in a peripheral vein to 15% (evidence?).

2) We keep them about 4 weeks and change them after that - sort of a trade off as every day increases the risk of an infection (read this

3) This article doesnt quite answer your question, but might give a you a basic idea of the problem.

[Guest kalamazoo]

We leave PICCs in until they are no longer needed. There are strict policies about cleaning the hub of the needleless ports to infuse meds and fluids. Dressings are changed only if loose and only by specially trained nurses using sterile technique. I am pleased to report we have a very low catheter infection rate at our facility. Centrally placed lines infuse glucose greater than 12.5%, peripheral no more than 12.5%. If inserted into the legs an xray is performed in A/P position and lateral to ensure the spinal vessels aren't cannulated.

[Stefan Johansson]

1) we use up to 30%, (we keep our PICCs always no more proximal than v cava superior)

2) we keep them as long as needed, and do not change them "per protocol". If there's a sepsis not responding as expected to regular antibiotic treatment, we take them out though.

3) we stopped doing this on a regular basis. we invariable got positive cultures from the picc tips, but had infants doing just fine

so we figured this was a systematic contamination.