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Preventing DVT in Peripherally Inserted Central CathetersDVT in Peripherally Inserted Central Catheters

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

From the Cardiovascular Division, Brigham and Women’s Hospital.

Correspondence to: Samuel Z. Goldhaber, MD, FCCP, Cardiovascular Division, 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 serves as a consultant for Baxter; Boehringer Ingelheim GmbH; Bristol-Myers Squibb; Daiichi Sankyo Company, Limited; Eisai Co, Ltd; Medscape from WebMD LLC; Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc; Portola Pharmaceuticals, Inc; and sanofi-aventis US LLC. He receives research support from Daiichi Sankyo Company, Limited; Eisai Co, Ltd; EKOS Corporation, Johnson & Johnson Services, Inc; and sanofi-aventis US LLC.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):589-590. doi:10.1378/chest.12-1710
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Extract

Imagine a set of assumptions that proves entirely incorrect. You order a peripherally inserted central catheter (PICC) for your hospitalized patient. False assumption 1: This is a PICC team procedure, and physicians do not really need to give this order much thought. The PICC team will figure out the largest catheter that can be safely inserted. At most, you will specify whether you want a single-, double-, or triple-lumen catheter. If unsure, order double lumen rather than single lumen or order triple lumen rather than double lumen; after all, to minimize the number of procedures, it is better to err on having more rather than fewer sites to infuse medications, blood products, and nutritional support. Eventually, the PICC will stop working. Its duration of function is mostly a matter of luck. The catheter may thrombose, but this is a minor problem. False assumption 2: An upper-extremity line-associated DVT is nothing more than a nuisance. It adds hardly a blip to the length of hospital stay and barely registers on the radar screen for incremental cost of hospitalization.

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