Related Experiment Video
Updated: Jan 28, 2026
The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
Should you pick the PICC? Prolonged use of peripherally inserted central venous catheters in children with intestinal
Kathryn LaRusso1, Geraldine Schaack2, Tiffany Fung1
1Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
Insights
Peripherally inserted central catheters (PICCs) show similar complication rates to Broviacs® in children with intestinal failure. PICCs may reduce hospital admissions related to central lines, suggesting potential benefits for vascular access in this population.
Area of Science:
- Pediatric Gastroenterology
- Vascular Access Management
- Intestinal Failure Treatment
Background:
- Prolonged central vascular access is a significant source of morbidity in pediatric patients with intestinal failure (IF).
- Multidisciplinary IF teams often utilize peripherally inserted central catheters (PICCs) to mitigate these risks.
- This study compares the outcomes of PICCs against Broviac® catheters in IF patients.
Purpose of the Study:
- To compare the complication rates and clinical outcomes of peripherally inserted central catheters (PICCs) versus Broviac® catheters in children with intestinal failure.
- To evaluate the efficacy of PICCs as a primary vascular access method in this vulnerable pediatric population.
Main Methods:
- Retrospective review of pediatric IF patients (2006-2018) at an academic children's hospital.
- Inclusion criteria: total parenteral nutrition duration >42 days or small bowel length <25% of gestational age.
- Complications per 1000 catheter days were analyzed using a Poisson model to compare PICCs and Broviacs®.
Main Results:
- Thirty-seven IF patients with 19,452 catheter days were analyzed (209 PICCs, 39 Broviacs®).
- No significant differences in complication rates per catheter day were found between PICCs and Broviacs® on multivariate analysis.
- Broviacs® demonstrated a trend towards increased catheter-related hospital admissions compared to PICCs.
Conclusions:
- Peripherally inserted central catheters (PICCs) exhibit comparable complication rates to Broviac® catheters in pediatric intestinal failure patients.
- PICCs may offer an advantage by potentially reducing catheter-related hospital admissions.
- Further experience and use of tunneled PICCs could enhance their benefits in pediatric vascular access.
Purpose:
Prolonged central vascular access is a source of significant morbidity in children with intestinal failure (IF). In an effort to decrease morbidity, our multidisciplinary IF team has primarily used peripherally inserted central catheters (PICCs) for these patients. We compared outcomes of PICCs to Broviacs®.
Methods:
A review of children with IF (2006-2018) at an academic children's hospital was conducted.
Inclusion Criteria:
total parenteral nutrition duration >42 days or small bowel length < 25% of total for gestational age. Complications/1000 catheter days were extracted, and a Poisson model was used to compare complications between PICCs and Broviacs®.
Results:
Thirty-seven patients with IF were included, accounting for 19,452 catheter days. There were 209 PICCs (1.2-4F) and 39 Broviacs® (2.7-7F). The median duration of overall PICC access/patient was 166 days (range: 35 days-8 years). Incidences of central line associated blood stream infection and venous thrombosis were 3.95 and 0.55 per 1000 catheter days, respectively. There were no significant differences in complication rates per line per catheter day between PICCs and Broviacs® on multivariate analysis. Broviacs® showed a trend towards increased of catheter-related hospital admissions when compared to PICCs.
Conclusions:
PICCs in children with intestinal failure have similar complication rates to Broviacs® but may reduce catheter-related hospital admissions. Use of tunneled PICCs and increasing experience with this vascular access method may allow it to realize its potential advantages.
Level Of Evidence:
Retrospective study, level III.
More Related Videos
09:57A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
09:17Use of a Central Venous Line for Fluids, Drugs and Nutrient Administration in a Mouse Model of Critical Illness
Published on: May 2, 2017
Related Concept Videos
01:09Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
01:23Anatomy of the Intestines
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the...
01:25The Central Dogma
01:20The Central Dogma
RNA is the Missing Link Between DNA and Proteins
In the early 1900s, scientists discovered that DNA stores all the information needed for cellular functions and that proteins perform most of these functions. However, the mechanisms of converting genetic information into functional proteins remained unknown for many years. Initially, it was believed that a single gene is...
01:04Venous Return
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
02:16Measures of Central Tendency