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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair

Ralph Gnannt1, Premal Patel2, Michael Temple2

  • 1Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue Toronto, Toronto, ON, M5G 1X8, Canada. ralph.gnannt@usz.ch.

Cardiovascular and Interventional Radiology
|February 1, 2017
PubMed

Insights

Repairing broken peripherally inserted central catheters (PICCs) in children is safer than replacing them. This study found lower central line-associated bloodstream infection (CLABSI) rates after PICC repair compared to exchange.

Area of Science:

  • Pediatric Interventional Radiology
  • Vascular Access Management

Background:

  • Preserving venous access in children is critical.
  • Broken peripherally inserted central catheters (PICCs) require immediate management, typically via repair or exchange.
  • Choosing the optimal management strategy is essential for patient outcomes.

Purpose of the Study:

  • To evaluate the outcomes of repairing broken PICCs in pediatric patients.
  • To compare the incidence of central line-associated bloodstream infections (CLABSI) between PICC repair and exchange.

Main Methods:

  • A single-center, retrospective study analyzed 235 cases of broken PICCs from 2010-2014.
  • Group A included 161 repaired PICCs; Group B included 74 exchanged PICCs.
  • CLABSI rates within 30 days post-intervention were compared.

Main Results:

  • PICC repair was successful in 68% of cases (Group A).
  • The 30-day CLABSI rate was 4.3% for repaired PICCs versus 10.9% for exchanged PICCs (Group B).
  • This difference was statistically significant after adjusting for antibiotic use (OR 3.87, p=0.039).

Conclusions:

  • Repairing broken PICCs in children is associated with a lower risk of CLABSI compared to exchange.
  • The findings support PICC repair as a preferred management strategy over removal or replacement.
Abstract

Keywords:
CatheterChildrenExchangeInfectionPICCRepair

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