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Trial registered on ANZCTR
Registration number
ACTRN12616001578493
Ethics application status
Approved
Date submitted
15/11/2016
Date registered
16/11/2016
Date last updated
25/09/2019
Date data sharing statement initially provided
25/09/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparing peripherally inserted central catheter outcomes in adults; a pilot randomised controlled trial
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Scientific title
Randomised controlled trial in adults of polyurethane PICC with endexo incorporated versus standard care polyurethane PICC to prevent PICC complication and failure
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Secondary ID [1]
290545
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None
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Universal Trial Number (UTN)
U1111-1189-8898
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Trial acronym
The PIC COMPARE trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Central venous access device failure prior to completion of therapy
300985
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Condition category
Condition code
Public Health
300780
300780
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients in this study have peripherally inserted central catheters (PICC) inserted in the RBWH department of medical imaging. Consenting patients (if appropriate) will have the type of PICC inserted randomised to either one of the following randomly assigned products
Arm 1: BioFlo polyurethane PICC with endexo technology
Arm 2 (Control): Arrow polyurethane PICC
The randomly allocated PICC will be inserted using standard technique for insertion and will remain insitu until completion of therapy, or complication requiring removal. Patients will be followed until device removal, the maximum duration of follow up is 4 weeks.
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Intervention code [1]
296405
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Prevention
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Intervention code [2]
296406
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Treatment: Devices
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Comparator / control treatment
Arm 2 (Control): Arrow Polyurethane PICC is a PICC line with a soft polyurethane plastic for increased patient comfort whilst still offering the stability and strength of first generation polyurethane with the ability to power inject contrast at higher pressures
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Control group
Active
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Outcomes
Primary outcome [1]
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PICC failure or complication: Composite measure of any reason for unplanned PICC removal or complication prior to the completion of therapy. This includes (i) central line-associated bloodstream infection (CLABSI); (ii) local infection of skin; (iii)device occlusion; (iv)venous thrombosis; (v) PICC fracture or dislodgement. The primary outcome of device failure is an objective measure, assigned by clinical staff (not research staff or investigators). This is routine clinical practice. Research staff will collect the primary endpoint from the medical records with additional information obtained from the clinical staff/patients if required.
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Assessment method [1]
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Timepoint [1]
300200
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Primary outcome [2]
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Primary Outcome: Feasibility of a full efficacy trial as established by:
*Eligibility: Percentage of patients screened that are eligible;
*Recruitment: Percentage of eligible patients who agree to enrol;
*Retention and attrition: Percentage of participants who are lost to follow up or withdraw from study;
*Protocol adherence: Percentage of participants who receive their allocated treatment throughout their study participation;
*Missing data: Percentage of data missed during study data collection;
*Parent and healthcare staff satisfaction and acceptability: Using a semi structured survey and
*Sample size estimates: a reduction in all-case CVAD failure or complication (Defined in the secondary outcomes) by at least 5% in the experimental arms, in comparison to standard care
*Biofilm formation will be identified on the internal and/or external lumens of the PICCs
Each component will be assessed by screening log, electronic data collection tool and any missed data will be obtained from electronic medical records.
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Assessment method [2]
300201
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Timepoint [2]
300201
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At study completion
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Secondary outcome [1]
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PICC-associated bloodstream infection (CABSI): A laboratory confirmed BSI that is not secondary to an infection at another body site (excludes Mucosal Barrier Injury LCBSI), with PICC in place for >2 calendar days on the day of the BSI (day of PICC placement being Day 1) and the PICC was in place on the date of the event or the day before, when all elements of LCBI, were first present together (see CDC NHSN for full criteria)confirmed by a blinded infectious disease specialist using de-identified clinical and microbiological data
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Assessment method [1]
329314
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Timepoint [1]
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [2]
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Local infection: Purulent phlebitis confirmed with a positive (greater than 15cfu) swab, but with negative or no blood culture, confirmed by blinded infectious disease specialist.
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Assessment method [2]
329315
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Timepoint [2]
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [3]
329316
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Occlusion: Complete: greater than or equal to 1 lumens cannot be flushed or aspirated, or resolved post thrombolytic dwell, Partial: use of thrombolytic to resolve a withdrawal aspirate when > or equal to 1 lumen flushes but does not easily aspirate, as determined by treating clinician and data entered into electronic data collection tool
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Assessment method [3]
329316
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Timepoint [3]
329316
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [4]
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Fracture: Visible split in PICC material; as examined by nursing staff and or leakage or radiographic evidence of extravasation/infiltration into tissue as determined by radiologist
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Assessment method [4]
329317
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Timepoint [4]
329317
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [5]
329318
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Venous thrombosis: suspected: too painful for the patient to tolerate, or Confirmed Ultrasound/venographic confirmed thrombosed vessel at the PICC site in a symptomatic patient, or a symptomatic patient with a thrombus/fibrin sheath occluding 1 or more lumen at PICC removal. The PICC material will be examined by nursing staff on device removal.
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Assessment method [5]
329318
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Timepoint [5]
329318
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [6]
329319
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Safety endpoints: Any local or systemic allergic reactions e.g. pruritis as assessed by research nurse and recorded in electronic data collection tool.
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Assessment method [6]
329319
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Timepoint [6]
329319
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [7]
329320
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PICC dwell time: hours from insertion until removal. This data will be collected on electronic data collection tool.
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Assessment method [7]
329320
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Timepoint [7]
329320
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [8]
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Patient acceptability: using 11 point numeric rating scales
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Assessment method [8]
329321
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Timepoint [8]
329321
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [9]
329322
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Healthcare costs: Composite measure of estimates of direct product costs, healthcare resource utilisation (including additional equipment, staff time) and failure-associated resource usage using previously established cost estimates
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Assessment method [9]
329322
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Timepoint [9]
329322
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At study completion.
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Secondary outcome [10]
329323
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Staff satisfaction and acceptability ranked on a 11 point scale
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Assessment method [10]
329323
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Timepoint [10]
329323
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At device insertion and removal of device, on complication or at 4 weeks whichever time point occurs first
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Secondary outcome [11]
329324
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Phlebitis - Any sign of chemical, mechanical or infective phlebitis as determined by patient complaint of pain and nurse examining PICC site
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Assessment method [11]
329324
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Timepoint [11]
329324
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At removal of device, on complication or at 4 weeks whichever time point occurs first
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Eligibility
Key inclusion criteria
Require PICC insertion at department of medical imaging for fluid or medication administration;
Able to provide informed consent
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*non-tunnelled, tunnelled, dialysis or implanted CVADs or pulmonary artery catheters;
*Current bloodstream infection
*PICC to be inserted through diseased, burned or scarred skin';
*Allergy to study product; and
*Previous study enrolment in this admission to hospita
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The research nurse (RN) will screen patients daily (screening Log kept). The study RN will gain informed consent and perform randomisation. The RN will have the study products in pre-packs and liaise closely with the ordering and inserting clinician. All eligible patients will be approached for written informed consent by the RN or inserter. If this is given, the staff member uses a centralised web-based randomisation service. Allocation is fully concealed until the patient is randomised.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomisation will be in a 1:1 ratio between the two study groups. Permuted blocks in randomly varied sizes will be used.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
23/01/2017
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Actual
2/05/2017
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Date of last participant enrolment
Anticipated
2/11/2017
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Actual
6/02/2018
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Date of last data collection
Anticipated
28/12/2017
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Actual
13/02/2018
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Sample size
Target
110
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Accrual to date
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Final
110
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
6935
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Royal Brisbane & Womens Hospital - Herston
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Recruitment postcode(s) [1]
14616
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4029 - Herston
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Funding & Sponsors
Funding source category [1]
294973
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University
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Name [1]
294973
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Griffith University
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Address [1]
294973
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Nathan Campus,
170 Kessels Road,
Nathan, QLD 4111
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Country [1]
294973
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Australia
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Funding source category [2]
294974
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Commercial sector/Industry
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Name [2]
294974
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Angiodynamics
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Address [2]
294974
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10 Glens Falls Tech Park,
Glens Falls,
New York
12801,
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Country [2]
294974
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United States of America
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Primary sponsor type
University
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Name
Griffith University
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Address
Nathan Campus,
170 Kessels Road,
Nathan, QLD 4111
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Country
Australia
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Secondary sponsor category [1]
293793
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None
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Name [1]
293793
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Address [1]
293793
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Country [1]
293793
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296332
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Children's Health Services Queensland
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Ethics committee address [1]
296332
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Level 7, Centre for Children's Health Research, 62 Graham Street, South Brisbane, QLD 4101
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Ethics committee country [1]
296332
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Australia
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Date submitted for ethics approval [1]
296332
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26/10/2015
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Approval date [1]
296332
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20/11/2015
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Ethics approval number [1]
296332
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HREC 15 QRCH 164
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Summary
Brief summary
Peripherally inserted central catheters (PICCs) were developed to provide short to medium term vascular access for patients requiring the infusion of vessel irritant medications, or frequent blood sampling. While PICC’s provide necessary, reliable and accessible vascular access; they are associated with biological, mechanical or infectious complication. These complications result in delayed treatment, need for reinsertion, and delayed treatment of the underlying complication - causing extended admission time, increased healthcare costs, venous depletion and increased morbidity and mortality. Microbial biofilm formation makes treatment of infections more complicated since the detached microbial cells from the biofilm can repeatedly infect the blood, and these microorganisms are highly resistant to many antimicrobial agents, frequently requiring PICC removal and antibiotic treatment. Maintaining catheter function is vital for the safe provision of treatment. BioFlo (trademark) PICC (by Angiondynamics; NY) claims to provide a novel solution and the manufacturers claim the material is resistant to blood products and biofilm development, reducing the risk of standard PICC complications including infection, fracture, thrombosis, leakage, localised swelling, accidental removal and dislodgement . These PICCs are now on the basis of some clinician preference at some Australian facilities. The effectiveness of this product at reducing PICC-associated complications as previously described has not been undertaken. We plan to undertake a randomized controlled trial at the RBWH. Patients who consent to participate in the trial will be randomly assigned to either study group. The primary aim of this research is to evaluate the feasibility of launching a full-scale efficacy trial, using pre-defined feasibility criteria for recruitment, retention and protocol fidelity. The secondary aim is to compare the effectiveness of this new PICC technology compared to older generation PICC relating to failure and complication due to infection, occlusion, dislodgement, thrombosis, or breakage, for adults with PICC in acute care.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Nicole Gavin
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Address
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Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street,
Herston, Queensland, 4029
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Country
70486
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Australia
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Phone
70486
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+61 7 3646 5833
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Fax
70486
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Email
70486
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[email protected]
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Contact person for public queries
Name
70487
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Nicole Gavin
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Address
70487
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Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street,
Herston, Queensland, 4029
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Country
70487
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Australia
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Phone
70487
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+61 7 3646 5833
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Fax
70487
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Email
70487
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[email protected]
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Contact person for scientific queries
Name
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Nicole Gavin
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Address
70488
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Centre for Clinical Nursing
Royal Brisbane and Women's Hospital
Butterfield Street,
Herston, Queensland, 4029
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Country
70488
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Australia
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Phone
70488
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+61 7 3646 5833
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Fax
70488
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Email
70488
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A comparison of hydrophobic polyurethane and polyurethane peripherally inserted central catheter: Results from a feasibility randomized controlled trial.
2020
https://dx.doi.org/10.1186/s13063-020-04699-z
N.B. These documents automatically identified may not have been verified by the study sponsor.
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