Peripherally inserted central catheter

A peripherally inserted central catheter (PICC or PIC line), less commonly called a percutaneous indwelling central catheter, is a form of intravenous access that can be used for a prolonged period of time (e.g., for long chemotherapy regimens, extended antibiotic therapy, or total parenteral nutrition) or for administration of substances that should not be done peripherally (e.g., antihypotensive agents a.k.a. pressors). It is a catheter that enters the body through the skin (percutaneously) at a peripheral site, extends to the superior vena cava (a central venous trunk), and stays in place (dwells within the veins) for days or weeks.

First described in 1975, it is an alternative to central venous catheters such as subclavian lines, internal jugular lines or femoral lines, which have higher rates of infection—subclavian and jugular line placements may result in pneumothorax (air in the pleural space of lung), while PICC lines have no such issue because of the method of placement.

In those who are very unwell PICC lines are appropriate when more than two weeks of treatment is needed.

Side effects include blood clots and infection.

Other complications may include catheter occlusion, phlebitis and bleeding. Urokinase or low-dose tPA may be used to break down obstructions. The type of occlusion (caused by medication precipitate or by thrombus) may determine which drug will be used in an attempt to clear the line. To decrease the risk of infection, particularly a blood stream infection, those involved in the management of the PICC must adhere to strict infection control procedures.

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