http://beckerinfo.net/JClub/2008/12/17/randomized-controlled-trial-of-peripherally-inserted-central-catheters-vs-peripheral-catheters-for-middle-duration-in-hospital-intravenous-therapy/ Division of Hospital Medicine Virtual Journal Club Mon, 30 Jan 2012 16:14:46 +0000 hourly 1 http://wordpress.org/?v=3.2.1 http://beckerinfo.net/JClub/2008/12/17/randomized-controlled-trial-of-peripherally-inserted-central-catheters-vs-peripheral-catheters-for-middle-duration-in-hospital-intravenous-therapy/comment-page-1/#comment-84 Robert Mahoney Thu, 08 Jan 2009 19:26:41 +0000 The article (http://www3.interscience.wiley.com/cgi-bin/fulltext/120119224/HTMLSTART) randomized consecutive admissions to an internal medicine service with a range of diagnoses who were anticipated to require IV treatments for 5 days or more. PICC lines were placed by interventional radiologists in a procedure suite using fluoroscopy and ultrasound; peripheral IV's were placed by nurses at the bedside. Because of the small number enrolled, there was appreciable diagnostic heterogeneity across the two groups that did not necessarily reach statistical significance (for example, 5/16.1% of PICC patients had cancer, versus 3/10.3% of peripheral IV patients), which may underlie some of the discrepancy in outcomes (although DVT formation in particular did not appear to correlate with particular diagnoses significantly). DVT's were treated in appropriate patients with 6 weeks of anticoagulation after catheter removal, which may not be uniform practice for asymptomatic catheter-associated DVT's. The article (http://www3.interscience.wiley.com/cgi-bin/fulltext/120119224/HTMLSTART) randomized consecutive admissions to an internal medicine service with a range of diagnoses who were anticipated to require IV treatments for 5 days or more. PICC lines were placed by interventional radiologists in a procedure suite using fluoroscopy and ultrasound; peripheral IV’s were placed by nurses at the bedside. Because of the small number enrolled, there was appreciable diagnostic heterogeneity across the two groups that did not necessarily reach statistical significance (for example, 5/16.1% of PICC patients had cancer, versus 3/10.3% of peripheral IV patients), which may underlie some of the discrepancy in outcomes (although DVT formation in particular did not appear to correlate with particular diagnoses significantly). DVT’s were treated in appropriate patients with 6 weeks of anticoagulation after catheter removal, which may not be uniform practice for asymptomatic catheter-associated DVT’s.

]]> http://beckerinfo.net/JClub/2008/12/17/randomized-controlled-trial-of-peripherally-inserted-central-catheters-vs-peripheral-catheters-for-middle-duration-in-hospital-intravenous-therapy/comment-page-1/#comment-83 Scott Gilbert Sun, 04 Jan 2009 05:34:34 +0000 More info needed on the study design: What time dates for data collection? Who placed PICC and PC? Specialist or not? What patient population? ICU or Oncology or Surgical? Techniques of PICC placement? MST or U/S used ? Guess I need to see the whole article. More info needed on the study design: What time dates for data collection? Who placed PICC and PC? Specialist or not? What patient population? ICU or Oncology or Surgical? Techniques of PICC placement? MST or U/S used ? Guess I need to see the whole article.

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