Safety of non-cuffed tunneled central venous catheters in adults with cystic fibrosis

Arshan Dehbozorgi, Badr Jandali, Robert Turner, Aaron Rohr, Brandon Custer, Kate Young, Carissa Walter, Lauren Clark, Yanming Li, Deepika Polineni, Joel Mermis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Peripherally inserted central catheters (PICCs) are the most common route of intravenous (I.V.) access for treatment of cystic fibrosis (CF) pulmonary exacerbations, but repeated PICC placement can result in upper extremity peripheral venous stenosis. Once peripheral stenosis develops, a non-cuffed tunneled central venous catheter (NcTCVC) is an alternative route for IV access. While these are regularly used at some CF centers, the safety and complication rate compared to PICCs in adults with CF has not been reported. This study aims to describe the safety of NcTCVCs in adults with CF. Methods: A retrospective cohort study was performed at a CF Foundation accredited institution including adults with CF who received NcTCVCs in interventional radiology from 7/19/2007 to 3/09/2020. Complications analyzed included catheter related deep venous thrombosis (DVT), central line associated blood stream infection (CLABSI), and catheter related central venous stenosis. Complications were considered attributable if they occurred while the catheter was in place or within 30 days of catheter removal. Results: During the study duration, 386 NcTCVCs were placed in 60 unique patients (55 % female) with a mean of 6.4 catheters per patient. Majority of NcTCVCs placed were 4 French (61.4 %). Average duration of indwelling NcTCVC was 16.2 days. No patients demonstrated catheter attributable symptomatic DVT. The incidence of DVT, CLABSI, and central venous stenosis was 0 (0 %), 4 (1 %), and 1 (0.3 %), respectively. Conclusions: Many adults with CF have required insertion of numerous PICCs for the treatment of recurrent pulmonary exacerbations. In those adults that develop PICC-associated peripheral vein stenosis precluding PICC placement, these results indicate NcTCVCs are a safe alternative.

Original languageEnglish
Article number101073
JournalRespiratory Medicine and Research
Volume85
DOIs
StatePublished - Jun 2024

Keywords

  • Central line blood stream infection
  • Cystic fibrosis
  • Deep venous thrombosis
  • Tunneled noncuffed central venous catheter
  • Venous stenosis

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