[Peripherally inserted central catheters: Savings, comfort, many advantages]

Area of Science:

• Pediatric critical care medicine
• Vascular access devices
• Interventional radiology

Background:

• Peripherally inserted central catheters (PICCs) are indicated for intravenous treatments exceeding 6 days or shorter durations with phlebotoxic medications.
• This study reports recent clinical experience with PICC placement in a pediatric population.

Purpose of the Study:

• To evaluate the safety and efficacy of peripherally inserted central catheters (PICCs) in pediatric patients.
• To assess the outcomes of PICC placement performed in the operating room versus the Pediatric Intensive Care Unit (PICU).

Main Methods:

• A retrospective study analyzed data from 2014-2015, including 66 pediatric patients who received 69 PICCs.
• Data reviewed included patient demographics, underlying conditions, catheterization procedures (OR vs. PICU, with or without ultrasound guidance), catheter type, duration, treatments, and complications.
• Complications assessed included infection, extravasation, obstruction, thrombosis, and mortality.

Main Results:

• Sixty-nine PICCs (3-5 Fr, 1-2 lumens) were placed in 66 patients (median age 5.71 years), primarily in pediatric surgery patients.
• Catheterization via arm veins was successful with only two accidental arterial punctures; no infectious complications occurred.
• Seven patients experienced extravasation (one chylothorax), three had parenteral nutrition-related obstructions resolved with heparin, and no clinical venous thromboses were observed. Median line duration was 10.6 days.

Conclusions:

• Peripherally inserted central catheters (PICCs) simplify patient management by avoiding repeated peripheral venipunctures.
• Performing PICC placement in the operating room before patient awakening enhances catheterization ease and reduces complications.
• The study supports the integration of PICCs into therapeutic protocols for selected pediatric patients.