“Routine PICC insertion in terminally ill cancer patients was comparable in safety and efficacy and resulted in superior satisfaction compared with usual IV access” Park et al (2020).
Purpose: The purpose of this study was to investigate whether routine insertion of PICC at admission to a hospice-palliative care (HPC) unit is acceptable in terms of safety and efficacy. Furthermore, whether it results in superior patient satisfaction compared to usual IV access.
Materials and methods: Terminally ill cancer patients were randomly assigned to two arms. 1) Routine PICC access and 2) usual IV access arm. The primary endpoint was IV maintenance success rate. This is defined as the rate of functional IV maintenance until the intended time (discharge, transfer, or death).
Results: A total of 66 terminally ill cancer patients enrolled and randomized into study arms. Among them, we analysed 57 patients (routine PICC, 29; usual IV, 28). In the routine PICC arm, mean time to PICC was 0.84 (range, 0-3) days. 27 patients maintained PICC with function until the intended time. In the usual IV arm, 11 patients maintained peripheral IV access until the intended time. 15 patients underwent PICC insertion. The IV maintenance success rate in the routine PICC arm (27/29, 93.1%) was similar to that in the usual IV arm (26/28, 92.8%, p=0.958). Patient satisfaction at day 5 was better in the routine PICC arm (97%, ‘a little comfort’ or ‘much comfort’) compared with the usual IV arm (21%) (p <0.001).
Conclusion: Routine PICC insertion in terminally ill cancer patients was comparable in safety and efficacy. It resulted in superior satisfaction compared with usual IV access. Thus, routine PICC insertion could be considered at admission to the HPC unit (NCT03299868).
Park EJ, Park K, Kim JJ, Oh SB, Jung KS, Oh SY, Hong YJ, Kim JH, Jang JY, Jeon UB. Safety, Efficacy, and Patient Satisfaction with Initial Peripherally Inserted Central Catheters Compared with Usual Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study. Cancer Res Treat. 2020 Dec 22. doi: 10.4143/crt.2020.1008. Epub ahead of print. PMID: 33355838.