Risk of device failure similar with different peripherally inserted central catheter materials

For patients referred for peripherally inserted central catheters (PICCs), the risk for device failure is not lower with hydrophobic or chlorhexidine PICCs versus standard polyurethane ones, according to a study published in the New England Journal of Medicine.

Amanda J. Ullman, Ph.D., from the University of Queensland in Brisbane, Australia, and colleagues conducted a randomized, controlled, superiority trial in three tertiary hospitals involving adults and children who were referred for PICC placement. Participants were randomly assigned to receive a hydrophobic or chlorhexidine PICC or a standard polyurethane PICC (365, 365, and 368, respectively) and were followed for eight weeks.

The researchers found that device failure occurred in 5.9, 9.9, and 6.1% of participants in the hydrophobic, chlorhexidine, and standard polyurethane groups, respectively (risk difference: hydrophobic versus standard polyurethane, −0.2 percentage points (95% confidence interval, −3.7 to 3.2; P = 0.89); chlorhexidine versus standard polyurethane, 3.8 percentage points (95% confidence interval, −0.1 to 7.8; P = 0.06)).

The odds ratio for device failure was 0.96 (95% confidence interval, 0.51 to 1.78) and 1.71 (95% confidence interval, 0.98 to 2.99) in the hydrophobic versus the standard-polyurethane group and in the chlorhexidine versus the standard-polyurethane group, respectively. Complications from any cause during the period of PICC placement occurred in 21.5, 38.6, and 21.7% in the hydrophobic, chlorhexidine, and standard-polyurethane groups, respectively.

“The current findings reflect the complexity in preventing multifactorial PICC dysfunction, with no apparent difference in the incidence of device failure or of catheter-acquired bloodstream infection according to PICC type,” the authors write.

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