The meta-analysis showed that multi-lumen CVCs are not an independent variable for higher colonization or the occurrence of CRBSI. The problem was also assessed by means of a meta-analysis 26 and a review investigating both colonization rate and catheter-related bloodstream infection (CRBSI) in multi-lumen and single-lumen CVCs.
#Parts of triple lumen catheter trial
Guidelines from the Centers for Disease Control and Prevention (CDC) 16 and a randomised clinical trial 25 indicated that when comparing multi-lumen central catheters (CVCs) with single-lumen central catheters, the former showed a higher incidence of infections. Thrombosis rates were statistically higher in the larger diameter catheters (p = 0.001).
Grove and Pevec 24 reviewed the records of 678 patients with PICCs. Other researchers determined that a larger external diameter of the catheter increases the risk of venous thrombosis. Other statistically significant risk factors were noted, however the authors concluded that the number of lumens was not a factor in the development of thrombosis. Yi et al 23examined predictive risk factors for thrombus formation in patients with PICCs using ultrasound.
Zochios et al 22 concluded that larger, multi-lumen PICCs demonstrated a higher incidence of thrombosis due to turbulence and restricted blood flow. The number of lumens and the size of the catheter have been described as risk factors for thrombus formation 21. Anticoagulation can be initiated, preventing further complications. Not all occlusions lead to upper extremity venous thrombosis (UEVT), and thrombotic occlusions can be treated with antithrombotic agents, while UEVT is treated symptomatically or with catheter removal. The literature describes occlusion rates in PICCs and links them to the number of lumens selected, reporting occlusion rates ranging from 7% to 34%, with fibrin sheath formation being a common cause of mechanical occlusion 20. Depending on the clinical situation, preference should be given to single-lumen devices as outlined in clinical practice guidelines 16-19. These findings have prompted a greater focus on ensuring appropriate use of the PICC in hospitalised patients, including recommendations on the “appropriate choice of vascular access type 16-17“.ĭouble and triple-lumen PICCs (Figure 2) are associated with an increase in occlusion. Ī recent study, for example, found considerable variation in the use of the PICC, indications for use and associated complications in a sample of 10 hospitals 15. However, the choice of device may in some cases be due to the limited information defining the appropriate indications for use of the single-lumen (Figure 1) versus the multi-lumen PICC 14.
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