PICNIC (chlorhexidine vs. polyurethane PICC)
Trial question
What is the effect of chlorhexidine-coated peripherally inserted central catheter for the prevention of device failure and complication?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
40.0% female
60.0% male
N = 733
733 patients (295 female, 438 male).
Inclusion criteria: adults and children referred for peripherally inserted central catheter placement.
Key exclusion criteria: current catheter-related bloodstream infection; thrombosis in vein where peripherally inserted central catheter is to be inserted; sensitivity to any of the study drug; admission due to COVID-19 infection.
Interventions
N=365 chlorhexidine PICC (chlorhexidine-coated peripherally inserted central catheter with external clamps, 4-5 Fr [Arrowg+ard Blue Advance™]).
N=368 standard PICC (polyurethane peripherally inserted central catheter with external clamps, 4-5 Fr [PowerPICC™]).
Primary outcome
Device failure
9.9%
6.1%
9.9 %
7.4 %
5.0 %
2.5 %
0.0 %
Chlorhexidine
PICC
Standard
PICC
No significant
difference ↔
No significant difference in device failure (9.9% vs. 6.1%; OR 1.71, 95% CI 0.98 to 2.99).
Secondary outcomes
Significant increase in complications from any cause (38.6% vs. 21.7%; OR 2.35, 95% CI 1.68 to 3.29).
No significant difference in duration of peripherally inserted central catheter placement (27.5 days vs. 28.8 days; MD -1.2, 95% CI -3.8 to 1.3).
No significant difference in infectious complications (4.4% vs. 3.9%; OR 1.22, 95% CI 0.57 to 2.59).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adults and children referred for peripherally inserted central catheter placement, chlorhexidine PICC was not superior to standard PICC with respect to device failure.
Reference
Amanda J Ullman, Deanne August, Tricia M Kleidon et al. A Comparison of Peripherally Inserted Central Catheter Materials. N Engl J Med. 2025 Jan 9;392(2):161-172.
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