Peripherally Inserted Central Catheters in Children: A Prospective Single-Center Analysis of Associated Complications

Highlights

• Overall, 72% (n = 63) of PICCs remained in situ until intended therapy was completed.

• In 24% (n = 21) of catheters, a PICC-associated complication resulted in premature removal.

• Leading all-cause complication was catheter malfunction (12% or 2.04 per 1000 catheter-days).

• Leading complication in uncuffed PICCs was catheter malfunction (4.12 per 1000 catheter-days).

• Leading complication in cuffed PICCs was infection (0.73 per 1000 catheter-days).

Abstract

Objective: To assess performance of peripherally inserted central catheters (PICCs) in pediatric patients Design: Prospective observational study

Setting: Academic pediatric tertiary referral center

Study Population: Children aged less than 18 years with PICCs inserted in Interventional Radiology from January 2019 to June 2019

Outcome Measures: Number of catheters remaining in situ until completion of intended therapy; and for those removed prematurely, the type and rate of complications

Results: A total of 88 PICCs (40 uncuffed, 48 cuffed) were inserted in 77 children. Overall, 72% (n = 63) of all catheters remained in situ until intended therapy was completed. Complications resulting in premature removal occurred in 24% of catheters (rate of 3.89/1000 catheter-days). Complications included catheter malfunction (2.04 per 1000 catheter-days), infection (1.67 per 1000 catheter-days), and thrombosis (0.18 per 1000 catheter-days). Complications were further recorded by catheter type. In patients with uncuffed catheters, the overall complication rate was observed to be 6.74 per 1000 catheter-days. In patients with cuffed catheters, the overall complication rate was observed to be 1.10 per 1000 catheter-days.

Conclusions: Findings suggest that cuffed PICCs may provide additional benefits toward optimizing catheter performance and securement in neonatal and pediatric patients. This can contribute to improved likelihood of complication-free PICC therapy and successful therapy completion. Pediatric patients present unique challenges and considerations for clinicians planning PICC therapy. Additional studies are needed to identify effective strategies to mitigate catheter failure in neonatal and pediatric populations.