Does anyone have data regarding the differences in infection risk of having a long term Subclavian vs PICC cath for routine abx. assuming the same type of catheter is used (PICC in subclavian site)?
Using a PICC in a subclavian site is an off label use. So I would not recommend it. Infection risks are virtually the same. The subclavian insertion site has a higher number and more types of microorganisms than the skin of the upper extremity, so that would tend to increase the risk of infection within the first week to 10 days. After that, the infection risks shifts to the intraluminal introduction of orgranisms and the risk for each type of catheter is the same. This risk all depends upon what is done to the catheter hub, how often it is manipulated, how well the connector surfaces are protected and cleaned, how well the IV sets are maintained for intermittent use, how frequently the continuous sets are disconnected (if at all). Since you specified long term use, I would focus on the intraluminal risk which would be the same regardless of the type of catheter in use. Lynn
Using a PICC in a subclavian site is an off label use. So I would not recommend it. Infection risks are virtually the same. The subclavian insertion site has a higher number and more types of microorganisms than the skin of the upper extremity, so that would tend to increase the risk of infection within the first week to 10 days. After that, the infection risks shifts to the intraluminal introduction of orgranisms and the risk for each type of catheter is the same. This risk all depends upon what is done to the catheter hub, how often it is manipulated, how well the connector surfaces are protected and cleaned, how well the IV sets are maintained for intermittent use, how frequently the continuous sets are disconnected (if at all). Since you specified long term use, I would focus on the intraluminal risk which would be the same regardless of the type of catheter in use. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861