Clinical experience with peripherally inserted central catheters in patients undergoing lung resections

Objective: In the general thoracic surgery department peripherally inserted central catheters (PICCs) may be an alternative option to standard central and peripheral venous catheters for patients undergoing surgical procedures and possible candidates to adjuvant chemotherapy. We report the results of our experience with PICCs in patients undergoing lung resections. Materials and Methods: We retrospectively reviewed data of 54 PICCs inserted in adult patients who underwent lung resection. Rate of complications at insertion and during maintenance were recorded. Each patient was followed from the implant to the removal of the device (median 20 days, range 10-370 days). In 23 cases PICCs were also used for adjuvant chemotherapy. Results: Insertion was successful in 98% of cases. There were no major complications and 15% minor complications (local hematoma, repeated punctures of the vein, difficulty in progression of the catheter and malposition) at insertion. During maintenance there were no episodes of catheterrelated bloodstream infection; two (3,7%) episodes of symptomatic thrombosis occurred during the chemotherapy period, associated to deep vein thrombosis of the legs, treated with medical therapy. Accidental removal of the catheter was observed in one patient. Removal of the catheter was never required because of complications. Conclusion: PICCs are a useful and safe device for patients undergoing lung resections. Their insertion is successful in 98% of cases and is not associated with significant risks, even in patients with coagulation disorders. Their maintenance is associated with an extremely low rate of infectious and non-infectious complications.