Peripherally Inserted Central Catheters Tied to Severe Allergic Reactions

A new study out this week found that peripherally inserted central catheters (PICC) that use a magnetized tip to guide insertion were associated with serious allergic reactions in patients. Published in Infection Control & Hospital Epidemiology, the journal for the Society of Healthcare Epidemiology of America, the study’s researchers found that severe adverse reactions occurred in patients within minutes of PICC insertion.

PICCs are long intravenous lines inserted through a small vein in the upper arm and into the chest to administer medication or nutrition over a prolonged time period. PICC lines are an alternative to central venous catheters, which require more training for insertion and are associated with more serious complications and infections.

“Our findings emphasize the need to recognize and carefully evaluate adverse reactions following PICC insertion and not to discount them as fainting episodes,” said study lead author John Conly, MD, a professor of medicine at University of Calgary and Alberta Health Services, Canada, in a release. Because the study is observational, Conly noted, it cannot be used to determine the cause of the reactions.

Researchers from Alberta Health Services and the University of Calgary began the study after reports emerged of serious adverse events following PICC insertions, including hypersensitivity and anaphylaxis reactions. The study compared adverse events at two hospitals that used two kinds of PICCs that employed the magnetized Sherlock Tip Locating System (TLS) with two hospitals that used PICC systems that do not use the magnetized system. The researchers used standardized definitions when studying the reactions because the symptoms and signs of hypersensitivity and anaphylaxis type reactions can be mimicked by other conditions.

The researchers identified 37 anaphylactic and anaphylactoid reactions among 8,257 insertions at two centers using PICC line systems that utilized the TLS while centers inserting similar products without the magnetized tip location system did not report any such reactions with 8,380 insertions.

More than half of the reactions were in patients with previously documented drug and environmental allergies, and a third had multiple allergies; and anaphylactic/anaphylactoid reactions occurred at higher rates among patients with cystic fibrosis, with 10% to 16% of cystic fibrosis patients having reactions compared to 0.5% of the general population.