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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Management of peripherally inserted central catheters (PICC) in pediatric heart failure patients receiving continuous

Maeve Giangregorio1, Sandra Mott1, Elizabeth Tong1

  • 1Boston Children's Hospital, Boston, MA.

Journal of Pediatric Nursing
|January 14, 2014
PubMed

Insights

Low-dose heparin may improve peripherally inserted central catheter (PICC) line patency in pediatric heart failure patients on continuous inotropes. Findings suggest heparin use is clinically significant, supporting current practices for maintaining PICC line function.

Area of Science:

  • Pediatric Cardiology
  • Vascular Access Management
  • Pharmacology

Background:

  • Peripherally inserted central catheters (PICCs) are crucial for administering continuous inotropes in pediatric heart failure.
  • Maintaining PICC line patency is essential to avoid complications and ensure effective treatment.
  • Current practices for maintaining patency, particularly regarding anticoagulation, require evaluation.

Purpose of the Study:

  • To evaluate the practice of maintaining PICC line patency in pediatric heart failure patients receiving continuous inotropes.
  • To compare the duration of PICC line patency and the need for thrombolytic agents between patients receiving low-dose continuous heparin and those receiving no heparin.

Main Methods:

  • A case-control retrospective chart review was conducted.
  • Two cohorts were compared: one receiving low-dose continuous heparin and one receiving no heparin.
  • Outcomes assessed included duration of PICC line patency (in days) and the requirement for thrombolytic agents.

Main Results:

  • The median duration of PICC line patency was 24 days for the heparin group versus 16 days for the no heparin group (p=0.07).
  • Thrombolytic agent use was 28% in the heparin group compared to 50% in the no heparin group (p=0.08).
  • While not statistically significant, the observed differences suggest a clinically significant benefit of heparin.

Conclusions:

  • Low-dose continuous heparin may be beneficial in maintaining PICC line patency in pediatric heart failure patients on inotropes.
  • Findings support the clinical significance of current practices involving heparin for PICC line maintenance.
  • Further prospective studies may be warranted to confirm these findings and establish optimal anticoagulation protocols.

Keywords:
CardiacHeart failureHeparinInotropeInotropic infusionPediatricPeripherally inserted central catheter

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