Port And/or Piic?

[JenniferInOhio]

I'm sorry, but what are the port and piic lines for? I've been reading posts for a couple of years, and I still don't understand what they are and what they are used for...

[Sunfish]

hi jennifer -

ports & PICC lines are two types of central intravenous catheters. they, in addition to another type called a tunneled catheter (more often known as a Hickman or Broviac line) are the most common options for long-term IV access and/or in any situation where peripheral IVs aren't an option for whatever reason. they are needed/ used for various reasons & the different types tend to be preferred for different reasons, though there is certainly some overlap. they all have their pros & cons. any indwelling IV line brings with it an increased risk of infection, and - even if the line isn't the infection source - if there is infection elsewhere in the body the line most often becomes infected as well & has to be removed/ replaced.

central lines are needed for certain types of infusions that are too caustic for perpheral lines. certain drugs (some antibiotics, chemo, etc) as well as intravenous nutrition (TPN, "total parenteral nutrition") will essentially "eat" peripheral veins such that central vein access is necessary. other people need central lines not b/c of what is being infused but b/c of the frequency of infusion/ blood draws &/or b/c their peripheral veins can't tolerate the frequency. in critical care situations central lines also allow for greater volume of infusion very quickly, aka a liter of fluid in an hour, which can't be done via a peripheral vein. central lines also last longer than peripheral lines & are considered "sturdier" such that they may allow someone to receive certain treatments at home that would otherwise require hospitalization. there are other reasons for use as well, but those are the "biggies" so to speak. most of the lines can also be used to draw blood, though there are some exceptions.

for a bit of info on the three types of lines....

a PICC line is the easiest/ least invasive to place. PICC stands for "Peripherally inserted central catheter" and the name is fairly self-descriptive. a PICC line is placed into the arm through a peripheral vein & then tunneled internally into a central vein. most often they can be placed bedside by a specially trained/ certified nurse, though some more difficult placements may be done in interventional radiology settings. only local anesthetic is used (a shot in the arm) & the placement usually isn't too painful (though this can vary a lot depending on a wide variety of factors). PICC lines are the shortest-lasting of the central lines. the length of use is a bit up for debate as you'll hear/ read anywhere from 3months to a year even amongst the "experts". there is some indication that PICC lines get infected more readily than other central lines but also that the infections are more likely to remain localized rather than evolving into systemic sepsis (b/c of their placement being in the arm). PICC lines are generally the first choice for anyone expected to need a central line for a shorter time period, i.e. IV antibiotics for a few weeks. if someone is hospitalized & there is continued difficulty with drawing blood &/or IV access a PICC line may be considered for the period of hospitalization. if not being used a PICC still requires flushing at least daily, and it can't get wet (so must be wrapped up for showering).

a port (port-a-cath, power port) requires surgical placement & thus sedation or anesthesia so is obviously more invasive. in a best case scenario a port can last for years, though this is by no means a certainty. the most common/ known use for ports is probably in cancer patients requiring ongoing but intermittant IV treatments, blood draws, etc. ports are implanted under the skin, most often in the upper chest area (with a catheter that threads into a central vein), so that when not being used ("accessed") there is nothing external. usually the only evidence is a bump under the skin and/or the scar from the initial placement. if not being used a port only requires care on a monthly basis and there are no restrictions on showering/ bathing/ swimming. in order to be used, however, a port must be "accessed". this requires the placement of a special needle (known as a huber needle) through the skin & into the hub of the port, aka a big poke! for those requiring daily infusion(s) this needle can be left in place for up to a week at a time, at which point is must be changed. when accessed the area must be covered/ wrapped in order to shower just like any other external IV line. some people (me included) learn to access their own port while others would have a nurse access.

a tunneled catheter (Hickman, Broviac) is external (like a PICC) but generally placed in the upper chest (like a port). the advantages/ disadvantages follow suit. they are generally more invasive to place/ remove than PICC lines but less than ports, longer-lasting than PICCs but shorter than ports, etc.

there are some other types of central lines, most often used in critical care situations, but they aren't generally used outside of a hospital setting. they usually aren't intended for more than a month of use and they aren't too practical for someone who is mobile, even if only to sit up in bed. i have scars from one of these lines in my neck that i call my "vampire bite". (yes, i have a dark sense of humor at times...)

i've had all of the above in varying quantities over the past few years and b/c of scarring (due to having needed so many lines) am now running into trouble with their placement. i wouldn't be alive now without my "lifelines" but they're not without their own troubles.

ok....class over. probably much more info than you wanted/ needed!

melissa

[JenniferInOhio]

Hey - thanks Melissa. I asked my hubby what they were a week or two ago and he said they were like a colonoscopy bag?? He was way off wasn't he?