In hospitals around the world, intravenous therapy, or IV devices, are inserted into patients’ arms to administer medication, provide fluids or draw blood. However, according to a new study conducted by a University Medical School team, a commonly used type of IV could pose serious health risks to patients.
The type of IV in the study is called a peripherally inserted central catheter, or PICC.
According to Vineet Chopra, assistant professor of Internal Medicine and a leader of the study, PICCs are much easier to use than normal IVs. Because PICCs can stay inserted for longer than other IVs, Chopra said patients can go home with them, resulting in less time in the hospital and added convenience for the patient. Furthermore, PICCs can reach all the way to the heart, whereas normal IVs end in the arm.
“If you think about IV devices, it’s usually the most common procedure performed in a hospital on patients,” he said. “Almost any patient that goes into the hospital has to have an IV. For the past decade there’s been dramatic improvements in technology of IVs, as well as devices available to patients.”
Though PICCs offer many advantages, Chopra’s research team also discovered serious risks associated with the devices. He said PICCs can cause blood clots, as well as serious infections. Catheter-associated bloodstream infections can result in hefty medical costs. He said the research suggests doctors should only use PICCs when they are absolutely needed, not as a matter of convenience.
Chopra noted that the research is aimed in part at helping patients and doctors make safe, informed decisions.
“What’s happened over the past several years is that we’ve seen more and more use in patients and as a result, more and more complications,” Chopra said. “Our research is really focused on trying to understand what drives the use of these devices. Are they appropriately used or are they sometimes used inappropriately? And can we in a way inform decision-making to prevent complications, so that the patients that use the devices are safer?”
PICCs are often used for chemotherapy treatment, which raised additional concerns with their use. Chopra said before PICCs, one of the only options cancer patients had for chemotherapy was the surgical insertion of a port. PICCS are much simpler than a surgical operation. Even so, Chopra noted that, not taking the inconvenience of the surgery into account, ports pose less of a health threat than PICCs do.
Additionally, in an effort to reduce medical complications, Blue Cross Blue Shield of Michigan is sponsoring a collaboration of 47 Michigan hospitals, called Michigan Hospital Medicine Safety Consortium. Internal Medicine Prof. Scott Flanders is the director of this collaborative initiative. He said these hospitals have decided to work together and help each other discover risk factors for patients, especially in regard to blood clots and PICC lines.
“Our collaborative works together to implement solutions,” Flanders said. “So if one hospital figures out how to better target these devices to lower risk patients and avoid use in higher risk patients, those hospitals have agreed to come share that information among all participants.”
Flanders also pointed to the significance of the team’s research and how the findings could make for better-educated providers and patients in the future.
“Some of the work that’s been done so far has highlighted the important variables that put a patient at increased risk to having a complication or problem related to that catheter,” Flanders said. “So when a decision needs to be made about these devices, it’s much more of an informed decision.”