Medical Care

The Dangers of Some IV Lines

Physicians need to more carefully consider the type of IV they use on patients, researchers say.

One kind of IV, known as a PICC line, is used to deliver medicines or have blood drawn over the course of days or weeks.

But while they’re popular, PICC lines also raise the risk of potentially dangerous blood clots.

A University of Michigan Medical School team has reviewed the medical literature and put together two guides for physicians to help them in deciding which patients should receive a PICC line, which should get less-risky devices, and how they can prevent or detect clots in patients with PICCs. All in all, the team wrote and published three papers.

“These devices are very popular, but in an under-the-radar way, because they make care more convenient and can be placed relatively easily,” says Vineet Chopra, M.D., M.Sc., the corresponding author on all three new papers and a hospitalist at the U-M Health System. “But our new results, and review of research on the topic, show it’s important for physicians to think hard about both the risks and the benefits.”

Chopra and his team focused on the risk of deep vein thrombosis, or DVT, among patients with PICC lines.  These blood clots can form in the arms of patients with PICC devices, causing pain, blocking the IV line and even breaking off and traveling to the lungs.

In their study, the researchers looked at records from 909 hospital patients who received PICCs at U-M in 2012 and 2013. Of that group, 268 patients developed a PICC-linked clot. Most of the clots developed in the first 10 days after the PICC went in.

The narrower a PICC line, the researchers discovered, the lower the risk of DVT. Patients who were taking aspirin and statins before they got their PICC had a lower risk. But patients who had surgery during their hospital stay, or had a history of deep clots, were likelier to get a PICC-associated DVT.

The results, says Chopra, indicate that doctors should use PICCs only when absolutely necessary, and that they should be more careful in considering the kind of patients who are the best candidates for PICCs. Additionally, they should monitor for clots, make sure patients continue to take aspirin and statins, and remove the PICC before any operation.

Patients should also do their part by asking what kind of IV device they are getting, what the risks are, and when it can be removed.

The findings were published in Thrombosis Research.

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