Intravenous Access Clinical Trial
Official title:
Comparison of Safety, Efficacy, and Patient-perceived Satisfaction Between Initial Routine Peripherally Inserted Central Catheters Insertion and General Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study
To establish the IV access strategy for terminally ill cancer patients, using comparisons of the safety, efficacy, and patient-perceived satisfaction between the initially routine PICC insertion group (routine PICC group) and general IV access group (optional PICC group).
Reliable intravenous (IV) access is an important issue in terminally ill cancer patients,
however, they have limited or no peripheral venous access due to edema or long period of IV
therapy. Thus, intravenous access has been provided by Central venous catheter (CVC).
There are some options for applying CVC in cancer patients; subclavian venous catheter (SVC),
chemo-port (CP), and the peripherally inserted central catheter (PICC).
When considering the characteristics of terminally ill cancer patients, such as poor general
condition and a limited period of survival, PICC could be a safe and effective method for
intravenous access.
There are two previous studies concerned about PICC study in terminally ill cancer patients.
They showed that PICC might be overall safe and efficient in terminally ill cancer patients.
However, these studies did not evaluate superiority of PICC insertion compared to no
insertion and the appropriate time for PICC insertion due to limitation of their design, such
as retrospective or single-arm observational study. Thus, strategies of PICC insertion for IV
access in terminally ill cancer patients have not been determined until now.
Considering the favorable results of PICC insertion in previous studies and limited survival
time of terminally ill cancer patients, the investigator postulated that routine PICC
insertion at the time of admission for terminal care would be effective for IV access.
Thus, the investigator assumed that initially routine PICC insertion would be non-inferior in
maintenance success rate / and complication rate compared to general IV access. In addition,
it would be superior in patient-perceived satisfaction. The inveistigator will undertake a
randomized phase II study to confirm the hypothesis.
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