Comparing PICC Materials: Do New Innovations Reduce Catheter Failure?

Peripherally inserted central catheters (PICCs) are widely used in both adult and pediatric patients, but complications like infections, thrombosis, and occlusions remain a concern. A recent randomized controlled trial compared different catheter materials to determine whether new technologies could reduce PICC failure rates.

Study Overview
The trial included 1,098 patients across three Australian hospitals, randomly assigned to receive one of three types of PICCs:

Hydrophobic PICC
Chlorhexidine-coated PICC
Standard polyurethane PICC (control group)
Patients were monitored for eight weeks, with the primary outcome being device failure due to infectious or noninfectious complications.

Key Findings
Device failure rates:
Hydrophobic PICCs: 5.9%
Chlorhexidine PICCs: 9.9%
Standard polyurethane PICCs: 6.1%
Complications were highest in the chlorhexidine group (38.6% of patients) compared to 21.5% (hydrophobic) and 21.7% (standard polyurethane).
No significant difference in failure rates between hydrophobic and standard PICCs, while chlorhexidine PICCs had a slightly higher failure risk.

Clinical Implications

• Hydrophobic PICCs did not significantly outperform standard polyurethane PICCs, suggesting no major advantage in switching materials.
• Chlorhexidine-coated PICCs had higher complication rates, indicating the need for further evaluation before widespread use.
• Ongoing research is needed to optimize PICC materials and prevent device-related complications.

Conclusion
While new catheter materials show promise, this study found no clear benefit over standard polyurethane PICCs in reducing failure rates. Future research should focus on refining catheter coatings and insertion techniques to enhance patient outcomes.

Authors: Amanda J. Ullman, Deanne August, Tricia M. Kleidon, Rachel M. Walker, Nicole Marsh, Andrew C. Bulmer, Ben Pearch, and Robert S. Ware