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The efficacy and safety of blood sampling through peripherally inserted central catheter devices in children
Marianne Knue1, Darcy Doellman, Kim Rabin
1Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Insights
Blood sampling via 3-Fr peripherally inserted central catheters (PICCs) is safe and effective in children. This practice does not significantly increase catheter occlusion, infection, or mechanical complication risks.
Area of Science:
- Pediatric Medicine
- Vascular Access Devices
- Clinical Research
Background:
- Peripherally inserted central catheters (PICCs) are vital for pediatric medication and fluid delivery.
- Blood sampling via PICCs is an alternative to venipuncture, potentially reducing needle-stick pain in children.
- Concerns exist regarding catheter occlusion and manufacturer recommendations against PICC blood sampling.
Purpose of the Study:
- To evaluate the efficacy and safety of blood sampling through 3-French (3-Fr) PICC devices in pediatric patients.
- To compare occlusion rates, infection rates, and mechanical complication rates between children with and without PICC blood sampling.
Main Methods:
- A sequential enrollment of children with 3-Fr PICCs into either a blood sampling group or a control group.
- Data collection included demographics, PICC details, infusate composition, and complication rates (occlusion, infection, mechanical).
- The primary outcome was the difference in catheter occlusion rates between the two groups.
Main Results:
- Blood sampling was successful in over 98% of cases, with an average of 4.4 samples per catheter.
- A slightly higher occlusion rate was observed in the blood sampling group, but this difference was not statistically significant.
- No significant differences were found in infection or mechanical complication rates between the groups.
Conclusions:
- Blood sampling through 3-Fr PICC devices is a feasible and effective procedure in pediatric patients.
- This practice does not lead to a statistically significant increase in catheter occlusion, infection, or mechanical complications.
- PICC blood sampling offers a viable alternative to venipuncture, potentially improving patient comfort and care satisfaction.
Background:
The peripherally inserted central catheter (PICC) is commonly used in children for medication and fluid administration. In addition, PICCs are used occasionally for blood sampling as an alternative to venipuncture. Blood sampling from these catheters carries the hypothetical risk of catheter occlusion caused by blood remaining in the catheter, and this practice is not supported by PICC manufacturers. Children often undergo multiple needle punctures, which are associated with pain, anxiety, and dissatisfaction with care. The authors hypothesized that blood sampling through 3-Fr PICC devices is effective and safe for children.
Methods:
After placement of a 3-Fr PICC, all the children were sequentially enrolled in one of two groups. The control group included patients that had 3-Fr PICC devices without blood sampling. The blood sampling group included patients with 3-Fr PICC devices through which blood samples were obtained. Demographic data, PICC placement and sampling data, infusate composition, catheter occlusion, mechanical complications, and blood stream infections were recorded. The primary outcome variable was the difference in occlusion rates between the two groups.
Results:
The analysis included 204 children with 3-Fr PICCs (120 in the blood sampling group and 84 in the control group) who had a mean age, 117.7 +/- 4.9 months. The mean PICC duration was 15.6 +/- 1.0 days. Blood sampling was successful more than 98% of the time from all blood sampling group catheters, with a mean of 4.4 +/- 0.5 samples removed from each catheter. There was a higher occlusion rate in the blood sampling group. However, this result did not reach statistical significance. There were no significant differences between the groups in terms of infection or mechanical complication rates.
Conclusions:
Blood sampling is feasible and effective through 3-Fr PICC devices in children. This practice is not associated with a significant increase in occlusion, infection, or mechanical complication rates.
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