Abstract:
Background: Patients in medical intensive care units (MICUs) often require prolonged intravenous therapy, making optimal catheter selection critical. While central venous catheters (CVCs) remain common, peripherally inserted central catheters (PICCs) are increasingly used. This single-centre retrospective study compared indwelling time, clinical utility, and complication profiles between PICCs and CVCs in MICU patients.
Methods: We analyzed 276 MICU patients with either a PICC or CVC, comparing catheter selection, length of stay, dwell time, and complication rates. Complication rates were also standardized per 1000 catheter-days.
Results: PICCs were used more frequently in patients with malignancy (P < 0.001) or requiring chemotherapy (P < 0.001), whereas CVCs were preferred in patients with chronic obstructive pulmonary disease (P = 0.012), diabetes (P = 0.012), COVID-19 (P = 0.020), or vasopressor infusion (P = 0.001). PICCs were associated with longer indwelling times (≥12 days, P < 0.001). In the unstandardized analysis, PICCs had higher rates of catheter dislodgement (P < 0.001) and occlusion (P = 0.005), but lower rates of puncture-site complications (bleeding, hypersensitivity, fluid leakage; all P < 0.05) and deep vein thrombosis incidence (P = 0.038). After standardization per 1,000 catheter-days, dislodgement remained significantly more frequent with PICCs, whereas the difference in occlusion was no longer statistically significant. No bloodstream infections occurred with PICCs, versus 5.4% with CVCs (P = 0.169). Because groups differed substantially in patient selection, clinical indication, dwell time, insertion site, and securement method, these findings should be interpreted as associations rather than evidence of superiority.
Conclusion: PICCs were associated with longer indwelling times and a higher rate of dislodgement, but lower rates of puncture-site complications and deep vein thrombosis; the difference in occlusion was no longer significant after standardization. Vascular access selection should be individualized according to patient characteristics, therapy requirements, anticipated duration, and device-related risks.
Reference:Long G, Jia C, Peng H, Li Y. Comparison of Peripherally Inserted Central Catheters versus Central Venous Catheters in a Medical Intensive Care Unit: A Single-Center Retrospective Study. Int J Gen Med. 2026 Oct 28;19:653773. doi: 10.2147/IJGM.S653773. PMID: 42968810; PMCID: PMC13724055.