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Sutured securement of peripherally inserted central catheters yields fewer complications in pediatric patients
Jeanine M Graf1, Christopher D Newman, Mona L McPherson
1Department of Pediatrics, Baylor College of Medicine, Section of Intensive Care, Texas Children's Hospital, Houston, Texas 77030, USA. jgraf@bcm.edu
Insights
Securing pediatric peripherally inserted central catheters (PICCs) with sutures significantly reduces complications compared to tape. Sutured PICCs demonstrated a lower complication rate, highlighting a superior method for pediatric catheter securement.
Area of Science:
- Pediatric vascular access
- Medical device securement
- Catheter-related complications
Background:
- Peripherally inserted central catheters (PICCs) are crucial in pediatric care.
- Current methods for securing PICCs include tape, sutures, and sutureless devices.
- No single PICC securement method has been established as superior.
Purpose of the Study:
- To compare the efficacy of tape versus suture securement for pediatric PICCs.
- To evaluate complication rates associated with different PICC securement techniques.
- To identify the optimal method for pediatric peripherally inserted central catheter securement.
Main Methods:
- A prospective randomized trial was conducted in pediatric patients.
- Catheter securement was performed using either tape or sutures.
- Complications and dwell time were systematically recorded for all participants.
Main Results:
- The study included 66 pediatric patients (34 suture group, 32 tape group).
- The overall complication rate was 5.8% for sutured PICCs versus 32.4% for taped PICCs.
- Common complications included catheter migration, occlusion, and leakage.
Conclusions:
- Sutured PICCs were associated with significantly fewer complications than tape-secured PICCs (p=.005).
- Suture securement represents a more effective strategy for pediatric peripherally inserted central catheters.
- This finding supports the adoption of suture securement to improve patient outcomes.
Background:
Pediatric peripherally inserted central catheters (PICCs) can be secured with tape, sutures, or sutureless securement devices. Despite widespread catheter use, no standardized method of securement has been proven superior.
Methods:
A prospective randomized trial of catheter securement with either tape or suture was undertaken in pediatric patients hospitalized at a tertiary children's hospital. Patient demographics, catheter dwell time, and all catheter complications were collected. All patients were followed for the entire dwell time of the catheter, including those discharged with lines still in place.
Results:
Sixty-six patients completed the study, with 34 children in the suture group and 32 children in the tape group. Patients' ages ranged from 9 months to 19 years. Overall complication rate in our sutured group was 5.8%, and 32.4% in the tape group.
Conclusions:
In this study of children of varying ages, sutured PICCs were associated with significantly fewer complications than those catheters secured with tape (p=.005). The 3 most common complications included migration, occlusion, and leaking catheters.
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