A new study done at the Johns Hopkins Children’s Center, Baltimore, MD, described online in JAMA Pediatrics, show that in children catheters inserted in a vessel in the arm or leg and not threaded into a large vein near the heart are nearly four times as likely to dislodge, cause vein inflammation, or dangerous blood clots as are catheters advanced into major vessels near the heart.
A peripherally inserted central venous catheter (PICC) placed into a small blood vessel, usually in the arm, and threaded toward a major blood vessel near the lungs and heart, is used as a temporary port for medications, nutrients, or fluids. However, clinicians sometimes leave the PICC line in a peripheral vein in the arm or leg instead, which, the researchers say, should only be done as a last resort.
Non-central, smaller veins, especially those in the arm, are narrower, thinner and more prone to injury than major vessels near the heart, the researchers say. Thus, a catheter can easily damage the protective coating on the walls of such veins and encourage the formation of blood clots that, in the worst-case scenario, can dislodge and travel to the lungs or heart, causing a pulmonary embolism or heart damage.
