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• W3175468045 abstract "We read with interest the report by Jasinski et al.1Jasinski P.T. Tzavellas G. Rubano J.A. Rutigliano D.N. Skripochnik E. Tassiopoulos A.K. A protocol for central venous access in patients with coronavirus disease 2019.J Vasc Surg. 2020; 72: 1507-1509Google Scholar The Italian Group of Venous Access Devices has recently suggested clinical recommendations for optimizing the practice of insertion and management of vascular access devices (VADs) in patients with coronavirus disease 2019 (COVID-19).2Scoppettuolo G. Biasucci D.G. Pittiruti M. Vascular access in COVID-19 patients: smart decisions for maximal safety.J Vasc Access. 2020; 21: 408-410Google Scholar,3Pittiruti M. Pinelli F. GAVeCeLT Working Group for Vascular Access in COVID-19Recommendations for the use of vascular access in the COVID-19 patients: an Italian perspective.Crit Care. 2020; 24: 269Google Scholar We totally agree that non–critically ill patients with COVID-19 often will not require a central VAD. In contrast, patients with COVID-19 admitted to the intensive care unit will often require a central VAD.1Jasinski P.T. Tzavellas G. Rubano J.A. Rutigliano D.N. Skripochnik E. Tassiopoulos A.K. A protocol for central venous access in patients with coronavirus disease 2019.J Vasc Surg. 2020; 72: 1507-1509Google Scholar, 2Scoppettuolo G. Biasucci D.G. Pittiruti M. Vascular access in COVID-19 patients: smart decisions for maximal safety.J Vasc Access. 2020; 21: 408-410Google Scholar, 3Pittiruti M. Pinelli F. GAVeCeLT Working Group for Vascular Access in COVID-19Recommendations for the use of vascular access in the COVID-19 patients: an Italian perspective.Crit Care. 2020; 24: 269Google Scholar However, the protocol suggested by Jasinski et al1Jasinski P.T. Tzavellas G. Rubano J.A. Rutigliano D.N. Skripochnik E. Tassiopoulos A.K. A protocol for central venous access in patients with coronavirus disease 2019.J Vasc Surg. 2020; 72: 1507-1509Google Scholar could lead to some confusion in the terminology and, thus, to an inappropriate use of the devices. Jasinski et al1Jasinski P.T. Tzavellas G. Rubano J.A. Rutigliano D.N. Skripochnik E. Tassiopoulos A.K. A protocol for central venous access in patients with coronavirus disease 2019.J Vasc Surg. 2020; 72: 1507-1509Google Scholar proposed trimming a triple-lumen peripherally inserted central catheter (PICC) such that the tip cannot reach the superior vena cava. However, by definition, such a device will no longer be a PICC but a peripheral VAD. According to the most recent data,4Qin K.R. Pittiruti M. Nataraja R.M. Pacilli M. Long peripheral catheters and midline catheters: insights from a survey of vascular access specialists.J Vasc Access. 2020 Oct 20; ([E-pub ahead of print])Google Scholar,5Qin K.R. Nataraja R.M. Pacilli M. Long peripheral catheters: is it time to address the confusion?.J Vasc Access. 2019; 20: 457-460Google Scholar peripheral VADs include short peripheral cannulas (<6 cm long), long peripheral catheters (6-15 cm long; so-called short midline catheters), and midline catheters (16-25 cm long; so-called midclavicular catheters, because the tip is in the axillary vein or subclavian vein). The “modified PICC” proposed by Jasinski et al1Jasinski P.T. Tzavellas G. Rubano J.A. Rutigliano D.N. Skripochnik E. Tassiopoulos A.K. A protocol for central venous access in patients with coronavirus disease 2019.J Vasc Surg. 2020; 72: 1507-1509Google Scholar should be classified as a peripheral catheter and included in the category of midline catheters. However, 20- to 25-cm, 4F to 5F, single-lumen and double-lumen catheters (ie, midline catheters) already exist and are commercially available; thus, no need exists to modify a PICC. These VADs are appropriate for patients with COVID-19 when a central VAD is not specifically needed.2Scoppettuolo G. Biasucci D.G. Pittiruti M. Vascular access in COVID-19 patients: smart decisions for maximal safety.J Vasc Access. 2020; 21: 408-410Google Scholar,3Pittiruti M. Pinelli F. GAVeCeLT Working Group for Vascular Access in COVID-19Recommendations for the use of vascular access in the COVID-19 patients: an Italian perspective.Crit Care. 2020; 24: 269Google Scholar If we required a 20- to 25-cm, 5F to 6F, triple-lumen catheter (which has been quite rare), we might even trim a PICC; however, we should be careful to name it properly, as a “midline” catheter. The unnecessary off-label modification of the length of a catheter is a very dangerous practice. Its use could generate confusion for clinicians, because they might erroneously use the “modified PICC” as a central catheter, leading to several local and systemic complications (eg, phlebitis, thrombosis, extravasation, and, even, severe tissue damage). EI and FB contributed equally and share co-first authorship." @default.
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• W3175468045 title "Terminology for vascular access devices" @default.
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