Peripherally Inserted Versus Centrally Inserted Central Venous Catheters in the Neurosurgical Intensive Care Unit

Study Overview
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Brief Summary
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This study aim to compare the cost-effectiveness and safety between centrally and peripherally inserted central venous catheters in neurosurgical intensive care unit patients.

Official Title
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Peripherally Inserted Versus Centrally Inserted Central Venous Catheters in the Neurosurgical Intensive Care Unit. Comparative of Cost-Effectiveness and Safety

Conditions
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Thromboses, Venous, Infection, Economic Problems

Intervention / Treatment
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* Other: PICC(Peripherally inserted central catheter)
* Other: CVC(Central venous catheter )


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients admitted to the neurosurgical intensive care unit , who require central access for the treatment of their illness. Exclusion Criteria: Insertion of the central catheter in emergency situations; Anatomical abnormalities of upper extremity affecting PICC placement; Current or recent (within 1 month) diagnosis of bacteremia Current or recent (within 1 year with confirmed resolution by imaging) deep venous thrombosis; Presence of skin changes in the area of the puncture, such as thrombophlebitis, dermatitis, cellulitis, burn among others;

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PICC(Peripherally inserted central catheter)<br>Patients randomly assigned to receive a peripherally inserted central catheter(PICC). | Other: PICC(Peripherally inserted central catheter)<br>* The peripherally inserted central catheter with different sizes (French scale). Trained vascular access nurses will perform the insertion of the PICC, guided by ultrasound at bedside using the Seldinger technique. A suitable sterile field will be established.<br>|
| Active Comparator: CVC(Central venous catheter )<br>Patients randomly assigned to receive a centrally inserted central venous catheter(CVC). | Other: CVC(Central venous catheter )<br>* The central venous catheter with different sizes (French scale). Trained doctors will perform the insertion of the CVC, using the Seldinger technique. A suitable sterile field will be established.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| thrombotic complications | radiographically-confirmed upper-extremity deep vein thrombosis | up to 30 days or be discharged from hospital | 
| mechanical complications | pneumothorax or hematoma caused by puncture | up to 30 days or be discharged from hospital | 
| infectious complications | catheter related bloodstream infection | up to 30 days or be discharged from hospital | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| catheter replacement | obstruction or accidental removal | up to 30 days or be discharged from hospital | 
| cost effectiveness | The cost of catheter implantation and replacement, as well as the cost of treatment due to catheter-related complications and the resulting financial loss to the patient. | up to 30 days or be discharged from hospital |