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Peripherally Inserted Central CathetersPeripherally Inserted Central Catheters: Bigger Is Not Necessarily Better

Samuel Z. Goldhaber, MD, FCCP
Author and Funding Information

From Cardiovascular Medicine Division, Venous Thromboembolism Research Group, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School.

Correspondence to: Samuel Z. Goldhaber, MD, FCCP, Harvard Medical School and the Cardiovascular Division, Venous Thromboembolism Research Group, Brigham and Women’s Hospital, 75 Francis St, Boston MA 02115; e-mail: sgoldhaber@partners.org


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Goldhaber has received grant support from Sanofi-Aventis, EKOS, Bristol-Myers Squibb, Boehringer Ingelheim, and J&J, and has been a consultant to Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, Sanofi-Aventis, EKOS, and Medscape.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(1):6-7. doi:10.1378/chest.11-0257
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Extract

As a cardiologist caring for hospitalized patients, I frequently order the placement of peripherally inserted central catheters (PICCs). This approach is safer than using the jugular, subclavian, or femoral vein for venous access, and the procedures for line placement are standardized and routine. Our hospital, like many others, has a nursing team that specializes in the insertion of these indwelling central venous catheters. Their expertise, honed by years of experience and aided by improvements in catheter/needle kit technology, maximizes the likelihood of successful line placement and minimizes the chance of complications such as fluid infiltration into surrounding tissues or catheter infection. PICCs are especially useful for the prolonged infusion of IV amiodarone and pressor agents. And when patients recover from the cardiovascular crisis that required hospitalization, PICCs are vital for hospital discharge planning, to facilitate extended courses of antibiotics such as vancomycin.

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