Peripherally inserted central catheter in oncology patients : incidence of venous thrombo-embolism

Abstract

Overview: Although central venous access devices (CVADs) are a frequent intervention for intravenous access with long-term chemotherapy, other treatment and blood monitoring, they can present serious complications like infection and venous thrombo-embolism (VTE). Peripherally inserted central catheters (PICCs) are a type of CVAD used for longterm venous access in oncology. The aim of this dissertation is to find out the incidence of VTE in cancer patients with PICC lines, and risk factors leading to its manifestation. Research question and PEO elements: The research question presented for this project was formulated using the PEO framework. It questions whether the use of PICCs influences the risk of VTE, including vein thrombosis and pulmonary embolism, in adult cancer patients. The 3 PEO elements are: adult cancer patients (Population), use of peripherally inserted central catheter (Exposure), incidence of venous thrombo-embolism and related risk factors (Outcome). The search process was done between April and September 2019. A total number of 8 articles were yielded from 3 databases: EBSCO, HyDi and Pubmed. Inclusion criteria: Adult cancer patients, use of peripherally inserted central catheter, PICC-associated venous thrombo-embolism, deep vein thrombosis, pulmonary embolism, English language articles, peer-reviewed articles. Exclusion criteria: Paediatrics, non-cancer patients, use of other central venous catheters, non- PICC related venous thrombo-embolism, foreign language articles. Appraisal method: The critical appraisal of the studies was carried out using the CASP tool for cohort studies. Ethical and legal issues were also discussed with relation to the studies’ methodologies. Results and conclusion: There were various findings from each study, which were analysed and compared. The answer of the research question was suggested to be yes; the PICC does increase risk of VTE in oncology, especially when certain risk factors are present. Recommendations: Proper PICC line maintenance and management of risk factors are needed to prevent VTE formation in cancer patients. Additionally, local research on the topic is desirable.