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Incidence of thrombosis in children with tunneled central venous access devices versus peripherally inserted central

Maralee Kanin1, Guy Young

  • 1Children's Hospital Los Angeles, CA, United States.

Thrombosis Research
|September 24, 2013
PubMed

Insights

This study found no significant difference in deep vein thrombosis (DVT) risk between peripherally inserted central catheters (PICCs) and tunneled lines in children. Both central venous catheter types pose a substantial risk for venous thrombosis.

Area of Science:

  • Pediatric Thrombosis
  • Vascular Access Devices
  • Central Venous Catheters

Background:

  • Deep vein thrombosis (DVT) is increasing in children, linked to central venous catheter use.
  • Tunneled lines and peripherally inserted central catheters (PICCs) are common, but their comparative DVT incidence is unclear.

Purpose of the Study:

  • To formally compare the incidence rate of deep vein thrombosis (DVT) between tunneled lines and peripherally inserted central catheters (PICCs) in pediatric patients.

Main Methods:

  • Retrospective analysis of pediatric patients (<18 years) admitted between July 2005 and July 2012.
  • Data extracted from hospital discharge database using ICD-9 codes for diagnoses and procedures.
  • Patients with single central line insertions were analyzed for DVT events and catheter type.

Main Results:

  • Overall DVT incidence was 2.6% (181/6915) over the study period.
  • Incidence was 2.6% for PICCs (152/5846) and 3.1% for tunneled lines (29/939).
  • No statistically significant difference in DVT incidence was detected between PICCs and tunneled lines (OR=0.83, p=0.38).

Conclusions:

  • Peripherally inserted central catheters (PICCs), despite ease of use, carry a substantial risk of venous thrombosis in children.
  • No difference in deep vein thrombosis incidence was observed between PICCs and tunneled central venous catheters.
  • Further research may be needed to mitigate DVT risks associated with central venous access in pediatric populations.
Abstract

Keywords:
CCCCHLACPTCVCCentral venous cathetersChildrenChildren’s Hospital Los AngelesDVTICD-9International Classification of Disease, 9th revisionLOSOROdds ratioPICCPeripherally inserted central cathetersTLTPNThrombosiscentral venous catheterchronic complex conditionscurrent procedural terminologydeep vein thrombosislength of stayperipherally inserted central cathetertotal parenteral nutritiontunneled lines

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