Infant peripherally inserted central catheter insertion without general anesthesia

Area of Science:

• Pediatric Anesthesiology
• Interventional Radiology
• Neonatal Care

Background:

• Anesthesia avoidance for infant peripherally inserted central catheter (PICC) insertion beyond the neonatal period is under-researched.
• Infants under 6 months and weighing under 5.5 kg represent a high-risk group for PICC procedures.
• A "Fast, Feed, and Wrap" (FFW) technique, adapted from MRI procedures, was introduced for this patient population.

Purpose of the Study:

• To evaluate the institutional experience with the FFW technique for infant PICC insertion.
• To determine the success rate of the FFW technique in eligible infants.
• To assess the proportion of qualifying infants managed using the FFW technique.

Main Methods:

• Retrospective study utilizing electronic records and case notes.
• Data collected included patient demographics (age, weight), procedure indication, anesthetic technique (general anesthesia vs. FFW), PICC details, and procedure duration.
• Analysis focused on infants undergoing PICC insertion using the FFW technique.

Main Results:

• Over 42 months, 51 infants qualified for FFW; 43 attempts were made, with 40 successful (93% success rate).
• All infants managed with FFW were >40 weeks postconceptual age, with 26% being preterm.
• Average age was 35 days, and median weight was 3.78 kg for infants undergoing FFW.

Conclusions:

• The FFW technique is a viable alternative to general anesthesia for infant PICC insertion in infants under 6 months and 5.5 kg.
• This approach demonstrates a high success rate and applicability in a significant proportion of eligible infants.
• FFW offers a promising method for non-anesthetic management of PICC procedures in this vulnerable pediatric population.