Percutaneous central catheter

Venous access is integral for numerous diagnostic and therapeutic procedures, particularly for critically ill patients requiring frequent blood sampling, medication administration, fluid resuscitation, and prolonged antibiotic therapy. Various methods, including peripheral intravenous (IV) lines, midline catheters, and central venous catheters (CVCs), facilitate access. Peripherally inserted central catheters (PICCs) are a subset of CVCs, providing medium-term access (several weeks to 6 months) by extending from a peripheral arm vein to the thorax. Central catheters terminate in the superior vena cava (SVC) or right atrium (RA), either centrally (CICC) or peripherally (PICC). PICCs are typically inserted via arm veins like basilic, brachial, or cephalic.
Indications for PICCs include limited peripheral access, long-term IV medication administration, continuous delivery of vesicants or irritating drugs, hyperosmolar solutions, blood product infusions, and frequent blood draws. The modified Seldinger technique is commonly employed for PICC placement, utilizing ultrasound guidance and sterile equipment. Despite benefits, indwelling catheters pose infection risks, including cellulitis, abscesses, and bacteremia. Hospital-acquired catheter-related bloodstream infections (CRBSIs) are commonly caused by coagulase-negative Staphylococci, Staphylococcus aureus, Enterococci, and Candida species. Preventive measures and vigilant care are crucial to mitigate these risks.