Factors associated with failures and outcomes of Peripherally Inserted Central Catheters in hospitalized COVID-19 patients

Abstract

Objective:  to analyze factors associated with catheter progression failure and outcomes of Peripherally Inserted Central Catheters inserted by nurses in hospitalized COVID-19 patients. Method:  observational cohort study was conducted with hospitalized COVID-19 patients, following the STROBE guidelines. Categorical variables were described as absolute and relative frequencies; quantitative variables were expressed as median and interquartile range. Non-parametric tests were applied due to non-normal distribution. Associations were analyzed using Pearson’s chi-squared or Fisher’s exact tests. Logistic regression was performed for variables associated with outcomes. Results:  a total of 1061 Peripherally Inserted Central Catheters were analyzed. The main indications were for antibiotic therapy, and most catheters were removed after treatment completion. First-attempt failure and clinical patient profile were associated with catheter progression failure. Subcutaneous heparin was a protective factor. Among Peripherally Inserted Central Catheters successfully inserted, tip confirmation via chest X-ray and catheter-to-vessel ratio between 31%-40% were associated with thrombosis, whereas Sherlock™ confirmation was protective. Conclusion:  catheter progression failure was associated with clinical conditions and first-attempt failure. Adverse outcomes were associated with X-ray tip confirmation and catheter-to-vessel ratio, whereas Sherlock™ use and subcutaneous heparin were protective factors.