SIze
Physical materials, e.g. polyurethane or medical silicone
Polyurethane |
Silicone |
Advantages
Disadvantages
|
Advantages
Disadvantages
|
Vascular Access Catheter TipS (2000) Polyurethane vs. Silicone http://www.norfolkaccess.com/TiPs/Polyurethane%20and%20SIlicone,%20a%20comparison.pdf |
|
Poiseuille's Law. States that the flow (Q) of fluid is related to a number of factors: the viscosity (n) of the fluid, the pressure gradient across the tubing (P), and the length (L) and diameter(r) of the tubing. | ![]() |
Single or multiple lumen
Multiple lumen allow separate infusion for each channel. Total Parenteral nutrition requires a dedicated lumen.
Valved and non-valved
Gravity infusion/Power-injectable
Pittiruti et al. (2012) report , a standard PICC with a small caliber (typically, 4 to 5 Fr) and length of (30 to 40 cm ), are associated with a high resistance to flow. A single-lumen 4 Fr PICC may achieve a flow rate of 2 to 3 ml/minute (by gravity infusion) and 10 to 11 ml/minute (with pump); the flow rates of a single-lumen 5 Fr PICC are only slightly higher (3 to 4 ml/minute by gravity and 11 to 13 ml/minute with pump). Double-lumen PICCs have worse performance in terms of flow, because increasing the number of lumens reduces the lumen size and further decreases the flow rate.
Power-injectable PICCs - single lumen (3, 4 or 5 Fr), double lumen (4 or 5 Fr) and triple lumen (6 Fr). They all share several features that make them particularly attractive for the ICU setting: low risk of mechanical and hemorrhagic complications at insertion, low risk of CRBSI, high flow (up to 300 ml/minute), easy monitoring of central venous pressure, low risk of lumen obstruction, and safe use for radio-diagnostic procedures. ❉ Always verify the power-injectable lumen.
Anti-thrombogenic/antimicrobial properties
References
Gilbert RE, Mok Q, Dwan K, Harron K, Moitt T, Millar M, Ramnarayan P, Tibby SM, Hughes D, Gamble C; CATCH trial investigators. Impregnated central venous catheters for prevention of bloodstream infection in children (the CATCH trial): a randomised controlled trial. Lancet. 2016 Apr 23;387.
https://pubmed.ncbi.nlm.nih.gov/26946925/
Gorski L., Hadaway L., Hagle M.E., McGoldrick M., Orr M., Doellman D. (2016). Infusion Therapy Standards of Practice (Revised 2016). Supplement to Journal of Infusion Nursing, 39(1), 1533-1458.
Neoh, K., Li, M., Kang, E., Chiong, E., & Tambyah, P. (2017). Surface modification strategies for combating catheter-related complications: Recent advances and challenges. Retrieved April 08, 2021, from https://pubs.rsc.org/en/content/articlelanding/2017/tb/c6tb03280j
Pittiruti, M., Brutti, A., Celentano, D., Pomponi, M., Biasucci, D. G., Annetta, M. G., & Scoppettuolo, G. (2012). Clinical experience with power-injectable PICCs in intensive care patients. Critical care (London, England), 16(1), R21. https://doi.org/10.1186/cc11181
Salis, A. I., Eclavea, A., Johnson, M. S., Patel, N. H., Wong, D. G., & Tennery, G. (2004). Maximal Flow Rates Possible during Power Injection through Currently Available PICCs: An In Vitro Study. Journal of Vascular and Interventional Radiology, 15(3), 275-281. doi:10.1097/01.rvi.0000116195.44877.88
Vascular Access Catheter TipS (2000) Polyurethane vs. Silicone
http://www.norfolkaccess.com/TiPs/Polyurethane%20and%20SIlicone,%20a%20comparison.pdf
Wildgruber M, Lueg C, Borgmeyer S, Karimov I, Braun U, Kiechle M, Meier R, Koehler M, Ettl J, Berger H. Polyurethane versus silicone catheters for central venous port devices implanted at the forearm. Eur J Cancer. 2016 May;59:113