Abstract

Aims: The aim of this systematic review is to examine the efficacy, safety, and costs associated with the short/intermediate-term use of peripherally inserted central catheters (PICCs) in comparison with centrally inserted central catheters (CICCs) and peripheral intravenous catheters (PIVCs) among adults in Europe.

Methods: Medline, EMBASE, Cochrane, and EconLit databases were searched for records dating from January 2000 to March 2017. Full-text versions of potentially relevant records were assessed according to prespecified inclusion and exclusion criteria.

Results: Of 457 identified records, 56 studies were included in the review. Data ranges for efficacy outcomes across studies did not suggest any clear advantages or disadvantages between PICCs and CICCs or PIVCs. However, individual studies reported statistically significant improvements in patient satisfaction with PICCs versus both comparators (P < 0.001) and fewer venipunctures for successful insertion compared with PIVCs (P < 0.01). Across studies, rates of removal due to complications were 3.5% to 48% with PICCs compared to 67% to 81.2% with PIVCs and 26% to 78% with CICCs. The proportion of patients reporting catheter migration/dislocation was 0% to 7.7% with PICCs compared to 9.6% to 15% with CICCs, whereas the rate of venous thrombosis was 0% to 27.2% versus 0% to 9.6%, respectively, with individual studies reporting significant differences (P ≤ 0.01). Limited evidence showed higher costs with PICCs than with CICCs or PIVCs, but not all relevant costs were included in the analyses.

Conclusions: This review showed that PICCs offer several advantages compared to CICCs and PIVCs, including greater patient satisfaction, fewer complications leading to removal, and less catheter migration/dislocation, despite a moderately higher rate of venous thrombosis.