Table 7.

Classification of various complications during PICC placement. Derived in accordance with Sona et al. [8].

Possible complications		Main causes	Consequences
Caregiver factor		Mainly due to the lack of adequate practice and knowledge of the healthcare staff but also poor hand hygiene regarding PICC insertion; the appropriate technique of patient care would lead to different complications.	May cause various intolerable complications including infections which could be induced from the moment of PICC placement
Minor complications		Minor complications include feeling local, phlebitis of a catheterized vein, slow withdrawal of blood that could be managed by applying secondary treatment. These complications do not require any hospitalization. Due to the lack of appropriate minor treatments or conservative management, these complications can not be managed properly.	Redness, inflammation of tunica intima of the veins, severe local pain induced by inflammation
Major complications	Infective complication	These kinds of complications could be caused by early removal of the PICC line. However, different factors could cause PICC-associated complications that should be managed and prevented appropriately.	Central line bloodstream infection (CLABSI)
	Thrombosis formation	These kinds of complications could be caused by early removal of the PICC line. Patients who are critically ill have a higher chance of being affected via PICC-related venous thrombosis	PICC-related venous thrombosis, deep vein thrombosis (DVT) and vascular thromboembolism
	Mechanical failure	These kinds of complications could be caused by early removal of the PICC line. While mechanical catheter complications are not life-threatening, they may hinder the treatment process and require PICC removal or replacement. Catheter malposition could cause thrombosis. Moreover, the lack of training and knowledge of nurses about mechanical complications may increase the rate of possible complications.	Inner lumen occlusions, catheter-related occlusion complications, catheter-related obstruction, coughing and vomiting (in critically ill patients), DVT and infection