***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose To compare the complications experienced for 2 different br and s of  peripherally inserted central venous catheters ( PICC ) , Cook Turbo-Ject and the Bard PowerPICC Solo2 . The rationale for this project revolved around concern that one of the PICCS in question had high rates of complications . Methods A prospect i ve clinical trial was conducted after obtaining approval from the University of Saskatchewan Human Research Ethics Committee . All PICCs were implanted at the Royal University Hospital Medical Imaging Department by an interventional radiologist . Patient r and omization was achieved by alternating the br and of PICC implanted in sequential patients . All the subjects were in patients from a single surgical ward . Patients were excluded from the study if they had a known uncorrected coagulopathy , or if they were being treated for venous thrombosis . This project was financially supported by the Summer Student Research Fund , College of Medicine , University of Saskatchewan . Results A total of 53 PICCs ( 25 Bard and 28 Cook ) were inserted over the study period . The mean PICC dwell time was 23.3 days for both the Bard and Cook PICCs , respectively . No statistically significant differences were detected in study group demographics , technical placement of the PICCs , or in the complications encountered . Discussion Both the Cook Turbo-Ject and the Bard PowerPicc Solo2 PICCs provided acceptable venous access for a wide variety of clinical indications PURPOSE The objective of this study was to evaluate and compare the relative durability and complications between the proximal valve polyurethane and distal valve silicone peripherally inserted central catheters ( PICCs )  . METHODS Institutional review board approval was obtained . A total of 326 patients ( mean age , 50.4 years ) was assigned r and omly to receive either a proximal valve polyurethane PICC ( n = 198 ) or a distal valve silicone Groshong PICC ( n = 194 ) . All PICCs were inserted under radiologic guidance by interventional radiologists . Follow-up data were collected until catheter removal because of complications or treatment completion . RESULTS The mean catheter dwell time was 25.6 days ( range , 1 - 245 days ) . Complications were encountered in 26.8 % and 47.9 % of the proximal valve polyurethane PICCs and distal valve silicone PICCs , respectively ( P < .001 ) . Significantly higher incidences of phlebitis ( 23.2 % versus 11.6 % , P = .003 ) and catheter-related infection ( 6.2 % versus 2 % , P = 0.043 ) were noted in the distal valve silicone PICCs . No significant differences in the incidence of catheter occlusion , fracture , or dislodgement were found . Multivariate logistic regression analysis showed a higher complication rate in the distal valve silicone PICCs corrected for patients ' age , sex , underlying morbidity , indication , peripheral vein accessed , arm used , catheter tip placement , and the number of venepunctures attempted . CONCLUSIONS Proximal valve polyurethane PICCs were more durable than distal valve silicone PICCs , which were associated with a higher incidence of phlebitis and infection , probably related to the material s of the catheters and the design s and placements of the catheter valves At our institution , a retrospective review of  peripherally inserted central catheters ( PICCs ) in oncology patients had previously demonstrated a complication rate of 40.7 % . Since then we have implemented strategies to reduce complications including staff and patient education , insertion technique modification and PICC maintenance utilizing a PICC nurse . The objectives of this study were to evaluate the recent PICC complication rate and to compare it with the previously reported findings . Prospect ively collected PICC complication data and medical records from all patients with solid tumours who had PICCs inserted in 2003 were analysed . A historical cohort comparative analysis was performed using our PICC complication rate from 2000 to 2001 . Eighty-eight PICC lines were inserted in 73 patients under radiological guidance .  The median PICC dwell time was 44 days ( 1 - 524 days ) . The overall complication rate was 15.9 % ( 14/88 ) or 2.0 complications per 1,000 PICC-days . Infections developed in 5.7 % ( 5/88 ) and thrombotic events occurred in 4.5 % ( 4 /88 ) of PICCs . The mean time to complication was 45 days . The complication rate for 2003 was significantly lower than the rate for 2001 ( P = 0.006 ) , especially of infective complications ( P = 0.004 ) . Strategies introduced to reduce PICC complications may have been the reason for this improvement PURPOSE To prospect ively evaluate outcomes associated with use of a triple-lumen ( TL ) peripherally inserted central catheter ( PICC ) in the intensive care unit ( ICU ) setting . MATERIAL S AND METHODS Patients were prospect ively enrolled in this HIPAA-compliant , institutional review board-approved study . Informed consent was obtained . All patients were in one hospital 's ICUs and needed intermediate-term central venous access requiring three lumina . A 6-F tapered TL PICC was placed by a bedside nursing-based team with backup from the Interventional Radiology department . Placement complications , as well as long-term complications , were recorded . At catheter removal , ultrasonography ( US ) of the veins containing the TL PICC was performed to detect occult venous thrombosis . Regardless of indication for removal , catheters were sent for culture to detect colonization . RESULTS The study was stopped prematurely after 50 of a planned 167 patients were enrolled when a scheduled interim analysis detected a  venous thrombosis rate that was considered unacceptably high by the study oversight committee ( thrombosis was symptomatic in 20 % of patients [ 10 of 50 ] ) . Venous thrombosis ( symptomatic or asymptomatic ) was detected in 26 of 45 patients ( 58 % ; 95 % confidence interval [ CI ] : 43 % , 72 % ) examined with US . Documented catheter-related bloodstream infection did not occur ( 0 % ; 95 % CI : 0 % , 7 % ) ; colonization was detected in three of 29 catheter tips sent for culture ( 10 % ; 95 % CI : 2 % , 27 % ) . Catheter malfunction and dislodgment occurred in one patient each . CONCLUSION The TL PICC design used in this study result ed in unacceptably high venous thrombosis rates . Even when used in a high-risk setting for infection ( ie , the ICU ) , rates of clinical ly evident infection and colonization were absent and low , respectively A retrospective study of patients ' records on review ing the purpose of venous catheter insertion ( chemotherapy , blood transfusion , antibiotics or parenteral nutrition ) ; total period of insertion ; reason for catheter removal . 120 admitted patients who received fluoroscopic guide PICC ( 4-French single lumen silicone rubber catheter ) insertions into distal SVC via antecubital region of forearm . We retrospectively review human factors including the patients ' laboratory data of pre- and post-insertion , total insertion period and reasons for withdrawal . The important human factors that affect the clinical outcome of PICC were also evaluated . The results indicated that the most common complications were wound oozing , phlebitis , occlusion , infection and leaking . Persistent wound oozing for over 3-day-period is the higher incidence of complication . It also demonstrated a surprisingly high ratio ( > 77 % ) in those patients with thrombocytopenia and leukemia . In this group , persistent low platelet counts could be noted , the ratio of failure ( remove PICC within 3 days ) is 10 % and there is 40 % decrease insertion period ( < 30 days ) . Prospect ively , it is worthwhile to choose new material or new technology of surface coating of PICC , to decrease consumption of platelet thrombogenic proteins and to maintain normal coagulate function of human bodies The purpose of this prospect i ve study was to evaluate the efficacy and complications associated with the use of 4-Fr single-lumen non-valved peripherally inserted central venous catheters ( PICC ) for the infusion of long-term antibiotics . Forty-four non-valved PICC were inserted using micropuncture technique by interventional radiologists . Six patients were lost to unrelated death or follow up . The remaining 38 patients ( 24 men and 14 women ; mean age 54.79 years ) were analysed .  Catheters were placed under ultrasound guidance using micropuncture technique and subsequently advanced over guidewire through peel-away sheath under fluoroscopic guidance . Doppler ultrasound was used before PICC removal in order to detect possible complications . All non-valved PICC were flushed with 5 ml of heparinized saline before and after each antibiotic infusion . Efficacy was evaluated and analysed on the average duration of catheter patency and whether any complication was present . Procedural success rate was 100 % in our patient population . Seven patients had complications necessitating early PICC removal with the average patency duration of 44 days ( 95 % confidence interval 7.79 - 80.21 days ) , whereas an average indwelling patency duration of the remaining 31 patients with no complication was 30.58 days ( 95 % confidence interval 25.74 - 35.43 days ) . Total complication rate was calculated to be 5.58 incidences per 1000 catheter days . Complication rate associated with the placement and use of 4-Fr non-valved PICC for antibiotic therapy was observed to be low when compared with other studies using valved and non-valved PICC for various infusates PURPOSE Peripherally inserted central catheters ( PICCs ) are frequently used to deliver outpatient courses of intravenous therapy . However , the rates and risks of complication for this device have not been well-studied . Our objective was to determine the incidence and risk factors of PICC-related complications with a 1-year prospect i ve observational study . PATIENTS AND METHODS All PICCs inserted in adult and pediatric patients at Memorial Sloan-Kettering Cancer Center ( MSKCC ) were followed prospect ively . The device insertion team , inpatient nurses , and various home-care companies and outside institutions collected longitudinal data . RESULTS Three hundred fifty-one PICCs were inserted during the study period and followed for a total of 10,562 catheter-days ( median placement , 15 days ; range , 1 to 487 days ) . Two hundred five PICCs ( 58 % ) were managed by home-care companies and outside institutions , and 146 PICCs ( 42 % ) were managed exclusively at MSKCC . For these 205 PICCs , 131 nurses from 74 home-care companies and institutions were contacted for follow-up clinical information . In all , 115 ( 32.8 % ) of 351 PICCs were removed as a result of a complication , for a rate of 10.9 per 1,000 catheter-days . Patients with hematologic malignancy or bone marrow transplant were more likely to develop a complication , whereas those with metastatic disease were less likely . CONCLUSION Complications occur frequently among cancer patients with PICCs , and long-term follow-up is onerous . Despite a high complication rate , the ease of insertion and removal argues for continued PICC use in the cancer population CONTEXT Oral administration of medication is often difficult in terminally ill cancer patients , and a subcutaneous route is traditionally one of the most preferred parenteral routes . Recent studies suggest , however , that some patients and families prefer the intravenous route , and peripherally inserted central venous catheters ( PICCs ) are actively used in oncology setting s. Nonetheless , in the palliative care setting , no empirical studies have investigated the patient-perceived usefulness of PICCs . OBJECTIVES The primary aim of this prospect i ve observational study was to clarify the levels of patient-perceived comfort and convenience , in addition to procedure-related distress , result ing from the use of PICCs by terminally ill cancer patients . RESULTS Among 219 patients admitted to a palliative care unit during the one-year study period , 39 ( 18 % ) patients underwent a PICC insertion trial  ( a total of 44 procedures were performed because five patients underwent PICC insertion twice ) . Of the 44 procedures , 38 ( 86 % ) were successful , requiring a mean of 23+/-7.9 minutes , without serious procedure-related complications . Patient-reported levels of procedure-related distress were not distressing ( 68 % ) , slightly distressing ( 8 % ) , and distressing ( 24 % ) . Patient-reported comfort levels with parenteral access were becoming more comfortable ( 94 % ) and no change ( 6 % ) . Patient-reported convenience levels of parenteral access were becoming more convenient ( 94 % ) and no change ( 6 % ) . Complications were reversible catheter coagulation ( 10 % ) , irreversible catheter coagulation ( 8 % ) , and mild levels of edema of the upper extremity ( 8 % ) . The PICCs remained in place in 82 % of the patients 
    Output:
    
Although both lines saw similar overall rates upon closer observation , the strengths and weaknesses of both lines are shown .
Polyurethane PICC lines were found to provide lower rates of infection , dislodgment , thrombus and rupture complications .
Mixed results were found with catheter line occlusions , overall averages showing polyurethane lines slightly higher rates than silicone .
Oncology patients however saw opposite results .
Conclusions Both silicone and polyurethane PICC lines exhibit nearly identical overall average postinsertion compilation rates ; however , it is the type of complications experienced that differ .
Overall , oncology patients can expect to experience higher levels of postinsertion complications