PICC Lines and Ports for People With CF

People with cystic fibrosis (CF) often need treatment with IV (intravenous) medications, most frequently antibiotics. Vascular access devices, including peripherally inserted central catheters (PICCs) and ports, permit ongoing access to the bloodstream. There are different types and brands. Your doctor will make recommendations based on the length of time the catheter will likely need to be used.¹

A traditional IV catheter is generally placed in the bend of the elbow or the back of the hand. They can easily get infected, cause irritation, or fall out.¹

PICC lines

A PICC is a medical device used to gain repeated access to someone’s veins. The purpose of this vascular or venous access is to improve delivery of IV medications.¹

PICC lines are a kind of catheter, sometimes called a tunneled catheter, made out of a long, thin, flexible tube. The tube is inserted into a large vein in the arm and threaded through the vein above the right side of the heart. PICC lines have an exposed section with a cap to cover the end of the tube. The line is attached to the skin with an adhesive and secured internally.^1,2

PICC lines are typically placed in the area around the elbow. Alternative locations are near the collarbone and side of the neck. Ultrasound or fluoroscopy are used to provide an image and make sure the catheter is placed correctly. A PICC line needs to be kept clean, flushed out after each round of treatment or once a week when not in use, and capped closed after each use. Each time an IV would ordinarily be needed, the cap is removed, and the medication attached to the tube for easy administration.^1,2

PICC lines are generally used over a period of weeks to months. Ports are used for longer-term access, over a period of years.¹

Ports

Ports are implantable devices, inserted beneath the skin. Ports are not visible except for the bump in the skin, which can be the size of a nickel or quarter. Like PICC lines, they are made from flexible plastic. A medical-grade rubber catheter is inserted into a large vein into which your doctor will attach a port.^1,2

The catheters come in a variety of sizes. They can be divided into lumens (multiple channels) to deliver multiple drugs if need be. Most often, people with CF who have ports implanted generally only need a port with 1 line.¹

Placing a port involves minor surgery and can be performed by a number of medical professionals including physicians, physician assistants, nurse practitioners, registered nurses, or radiology technicians. There is some care of the surgical site required after a port is implanted until the incision heals.^1,2

Ports have to be accessed to be used. A fine-gauge needle, called a Huber, can be inserted through the skin into the rubber part of the port. Wearing a bandage can help keep the area around the IV clean. The IV tube will extend out from the port through the bandage creating a way to connect the port to the medication. After the medicine has been completely delivered, the port needs to be cleaned. It should also be flushed out once a month when it is not in use.¹

Administering medications through a port can be done in a clinic or hospital. You may also do it at home by yourself or with the help of a caregiver, family member, or friend.¹

PICC line versus port

Determining whether a PICC or a port is the right choice for venous access is a decision made by your healthcare team. If you need antibiotics only occasionally you may get a PICC line. If medications are needed more often or if you have experienced problems with the placement of a PICC, you may be better off with a port. The port typically does not interfere with everyday activities. A PICC may limit some kinds of activities including certain kinds of exercise, heavy lifting, and swimming.^1,2

Both PICCs and ports require maintenance to keep the areas around them clean and germ-free. Flushing with saline or heparin after each infusion helps prevent the catheter from getting clogged.^1,2

Do you use a PICC line or a port? Share in the comments below!