Complications in the use of peripherally inserted central catheter associated with peripheral intravenous therapy: retrospective cohort.

The sample was convenience based and came from one tertiary public teaching hospital, so it may not represent other adult inpatient settings. The study used retrospective records and forms, and some complication counts differ between the text and tables, including secondary migration. Ultrasound guidance was used in only two insertions, so the findings may reflect limited vascular visualization technology rather than a controlled comparison of insertion sites. External jugular insertion was common and contrary to national and international recommendations, possibly because peripheral veins were depleted; this makes it hard to separate the effect of vein choice from vein condition. The study did not randomize PICC site or treatment, so associations with puncture number, insertion site, and complications do not prove cause. Some associations were seen only in crude models, such as PICC use time with complications, while the adjusted model was not significant. No training for committee nurses occurred during the study period, and vein choice was left to the inserting nurse.

Partly financed by CAPES, Finance Code 001, Brazil; no commercial conflict of interest is reported.

Do not conclude that external jugular insertion causes PICC removal or that choosing another vein will prevent complications. This was an observational cohort, external jugular use may have reflected depleted peripheral veins, and ultrasound was rarely used, so site choice was not randomly assigned or fully controlled.