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Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure

Hannah G Piper1, Nicole T de Silva, Joao G Amaral

  • 1Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.

Journal of Pediatric Gastroenterology and Nutrition
|December 11, 2012
PubMed

Insights

Peripherally inserted central catheters (PICCs) are a safe and effective option for long-term parenteral nutrition in infants with intestinal failure. This study found low rates of catheter-related bloodstream infections and venous thrombosis, supporting their use over traditional central venous catheters (CVCs).

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Care
  • Vascular Access Devices

Background:

  • Infants with intestinal failure require long-term central venous access for parenteral nutrition (PN).
  • Surgically placed central venous catheters (CVCs) are traditionally used but associated with significant morbidity.
  • Peripherally inserted central catheters (PICCs) offer potential advantages due to smaller size and placement without general anesthesia.

Purpose of the Study:

  • To report the use of PICCs for long-term PN delivery in infants with intestinal failure.
  • To compare PICC-associated complication rates with published data for CVCs and other PICCs.

Main Methods:

  • A 4-year retrospective review of infants (<12 months) with intestinal failure using PICCs for PN.
  • Determination of catheter-related bloodstream infection (CRBSI) and venous thrombosis incidence.
  • Comparison of complication rates with existing pediatric literature.

Main Results:

  • The study included 45 infants and 95 PICCs, totaling 10,189 catheter days.
  • The incidence of CRBSI was 5.3 per 1000 catheter days.
  • The incidence of venous thrombosis was 2.0 per 1000 catheter days.

Conclusions:

  • PICCs can be inserted without general anesthesia and avoid vein manipulation, offering advantages over CVCs.
  • Low rates of CRBSI and venous thrombosis support the use of PICCs.
  • PICCs are recommended for infants with intestinal failure requiring long-term PN.
Abstract

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