Good afternoon colleagues,
Â I have a critical care physician who is being particularly difficult getting on board with our Early Assessment PICC Program.Â More specifically, he states that there is a significant amount of research available to supportÂ NOT using PICCâ€™s because of the unknown incidenceÂ of risk forÂ upper extremity DVT.Â
I have found multiple research articles that conclude that Venous Thrombosis is a significant complication of PICC placement, and that it occurs more frequently than previously recognized.I am looking for some professional help inÂ approaching this physician with some alternate research thatÂ promotesÂ the use of PICC lines.
Is there anything out there that says the incidence of DVT is LOW?Â I believe that if appropriate assessment of risk factors are taken, as well as appropriate management of the PICC line including passive range of motion, the incidence of upper extremity DVT will be low - however this physician is RESEARCH driven and I need some help.Â Thank you for your time and consideration.
Out of curiosity......Â Kathy - What would you say to this physician?Lynn - What would you say?Thanks!Â
Here are some of my sources that say that the incidence of DVT with PICC's is high:
Chemaly, R. F. , de Parres, J. B., Rehmn, S. J. et al. (2002). Venous thrombosis associated with peripherally inserted central catheters: A retrospective analysis of the cleveland clinic experience. Clinical Infectious Diseases, 34, 1179-83.Â
Allen, A. W., Mergargell, J. L.. Brown, D. B et al. (2000). Venous thrombosis associated with the placement of peripherally inserted central catheters. JVIR,11, 1309-14.
Gonsalves, C. F., Eschelman, D. J., Sullivan, K. L., DuBois, N, & Bonn, J. (2003). Incidence of central vein stenosis and occlusion following upper extremity PICC and port placement.Â Cardiovascular Interventional Radiology, 26, 123-127.