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Published on: December 23, 2014
Are cuffed peripherally inserted central catheters superior to uncuffed peripherally inserted central catheters? A
Luke M H W Toh1, Ertugrul Mavili, Rahim Moineddin
1Division of Interventional Radiology, Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada. hwtoh@hotmail.com
Insights
Cuffed peripherally inserted central catheters (PICCs) offer superior, longer-lasting vascular access in children compared to uncuffed PICCs. Cuffed PICCs also demonstrated reduced rates of infection, malposition, and thrombus formation.
Area of Science:
- Pediatric vascular access
- Medical device efficacy
- Catheter-related complications
Background:
- Peripherally inserted central catheters (PICCs) are crucial for prolonged intravenous therapy in pediatric patients.
- The choice between cuffed and uncuffed PICCs may impact treatment outcomes and complication rates.
Purpose of the Study:
- To compare the effectiveness of cuffed versus uncuffed PICCs in pediatric patients.
- To determine if cuffed PICCs provide superior access duration until the end of therapy.
Main Methods:
- Retrospective review of PICCs inserted between January 2007 and December 2008.
- Data analysis included patient demographics, insertion details, and reasons for catheter removal.
- Primary outcome was the ability of PICCs to provide access until therapy completion.
Main Results:
- Cuffed PICCs (n=1,201) were significantly more likely to provide access until therapy completion than uncuffed PICCs (n=303) (P=.0002).
- Uncuffed PICCs showed higher rates of infection, malposition, and thrombus formation.
- In the NICU subset, cuffed PICCs trended towards better outcomes, though not statistically significant.
Conclusions:
- Cuffed PICCs are more effective in providing sustained vascular access in pediatric patients.
- Cuffed PICCs are associated with lower incidences of infection, malposition, and thrombosis compared to uncuffed PICCs.
Purpose:
To assess the use of cuffed peripherally inserted central catheters (PICCs) compared with uncuffed PICCs in children with respect to their ability to provide access until the end of therapy.
Materials And Methods:
A retrospective review of PICCs inserted between January 2007 and December 2008 was conducted. Data collected from electronic records included patient age, referring service, clinical diagnosis, inserting team (pediatric interventional radiologists or neonatal intensive care unit [NICU] nurse-led PICC team), insertion site, dates of insertion and removal, reasons for removal, and need for a new catheter insertion. A separate subset analysis of the NICU population was performed. Primary outcome measured was the ability of the PICCs to provide access until the end of therapy.
Results:
Cuffed PICCs (n = 1,201) were significantly more likely to provide access until the end of therapy than uncuffed PICCs (n = 303) (P = .0002). Catheter removal before reaching the end of therapy with requirement of placement of a new PICC occurred in 26% (n = 311) of cuffed PICCs and 38% (n = 114) of uncuffed PICCs. Uncuffed PICCs had a significantly higher incidence of infections per 1,000 catheter days (P = .023), malposition (P = .023), and thrombus formation (P = .022). In the NICU subset analysis, cuffed PICCs had a higher chance of reaching end of therapy, but this was not statistically significant.
Conclusions:
In this pediatric population, cuffed PICCs were more likely to provide access until the end of therapy. Cuffed PICCs were associated with lower rates of catheter infection, malposition, and thrombosis than uncuffed PICCs.
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