Evaluation of a novel flushing protocol for a peripherally inserted central catheter (PICC) in the neurological intensive care unit: A prospective randomized study.

Abstract

Peripherally inserted central catheters (PICCs) are increasingly used in critical care units. Venous arterial blood management protection (VAMP) for PICCs could decrease the rate of blockage of PICCs. We investigated whether a novel flushing method for PICCs could decrease the risk of venous thromboembolism (VT) and catheter-associated bloodstream infections (CABSIs) compared to the traditional flushing method. In this prospective randomized study, we evaluated 360 patients with PICCs who were admitted to our neurological intensive care unit from March 2012 to February 201 4. The patients were randomized into the experimental group (n= 186) and the control group (n= 174). The VAMP-system flushing method was used in the experimental group whereas in the control group the PICCs were flushed with a 10 ml syringe of saline. Baseline clinical information, blockage rate of PICCs, occurrence of VT and CABSIs and average time for flushing (seconds per flushing time) were compared and analysed. The occurrence of CABSIs and average time for flushing were statistically lower in the experimental group. The rate of blockage of PICCs, proportion of male subjects, age of subjects, APACHE II score and length of stay in hospital showed no significant differences between the two groups. This study showed that the VAMP-system flushing method is simple to use and may be more beneficial for patients with a PICC; it may also lower the risk of CABSIs.