Comparison of complications between pediatric peripherally inserted central catheter placement techniques

Area of Science:

• Pediatric Interventional Procedures
• Vascular Access Devices
• Medical Device Safety

Background:

• Peripherally inserted central catheters (PICCs) are common in pediatric hospital care.
• Sheathed needle techniques offer a potential simplification over the modified Seldinger technique for PICC insertion.

Purpose of the Study:

• To retrospectively evaluate the safety and efficacy of two PICC insertion techniques in a pediatric population.
• To compare complication rates between direct sheathed needle puncture and modified Seldinger techniques.

Main Methods:

• Retrospective review of 8,816 PICC placements over 4 years at a pediatric tertiary care center.
• Data collected included patient demographics, insertion technique, catheter details, and complication incidence (e.g., phlebitis, thrombosis).
• Statistical analysis using chi-square test to compare complication rates between techniques.

Main Results:

• Direct sheathed needle technique used in 94.9% of cases, modified Seldinger in 5.1%.
• Overall complication rates were similar: 3.7% for sheathed needle vs. 3.7% for Seldinger (P=0.99).
• Specific complication rates for multiple punctures, phlebitis, and thrombosis also showed no significant differences between the two methods.

Conclusions:

• Both the direct peel-away sheathed needle technique and the modified Seldinger technique are associated with comparable complication rates for pediatric PICC placement.
• The findings support the safety of the sheathed needle technique as a viable alternative in pediatric vascular access.