A Comparison of Peripherally Inserted Central Catheter Materials.
Summary
In a multicenter randomized superiority trial (n=1098), hydrophobic and chlorhexidine-impregnated PICCs did not reduce device failure compared with standard polyurethane catheters over 8 weeks. The chlorhexidine group had higher overall complications, challenging assumptions that antimicrobial-impregnated materials improve outcomes.
Key Findings
- No significant difference in device failure between hydrophobic (5.9%) and standard polyurethane (6.1%) PICCs (risk difference −0.2%, P=0.89).
- Chlorhexidine PICCs showed non-significantly higher device failure (9.9%) and significantly more complications overall versus standard polyurethane (OR 2.35, 95% CI 1.68–3.29).
- Trial included adults and children (n=1098) with 8-week follow-up and no intervention-attributable adverse events; registered (ACTRN12619000022167).
Clinical Implications
Standard polyurethane PICCs remain appropriate first-line. Focus should remain on insertion technique, care bundles, and surveillance rather than premium materials, and reconsider routine use of chlorhexidine-impregnated PICCs.
Why It Matters
Provides high-level evidence to guide PICC material selection across inpatient care, with immediate implications for procurement and prevention bundles. Negative results prevent low-value adoption.
Limitations
- 8-week follow-up may miss longer-term failures or cost-effectiveness differences.
- Composite endpoint may mask divergent effects on specific complications.
Future Directions
Evaluate cost-effectiveness and longer-term outcomes, and identify subgroups (e.g., high-infection risk) where materials might differ.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Level I: multicenter randomized controlled trial with predefined endpoints.
- Study Design
- OTHER