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Infant peripherally inserted central catheter insertion without general anesthesia.

Sarah Laing1, Laura L Burgoyne1, Michele Muncaster2

  • 1Department of Children's Anaesthesia, Women's and Children's Hospital, North Adelaide, SA, Australia.

Paediatric Anaesthesia
|June 20, 2020
PubMed
Summary
This summary is machine-generated.

The "Fast, Feed, and Wrap" technique successfully avoids anesthesia for infant peripherally inserted central catheter (PICC) insertion in infants under 6 months. This method achieved a 93% success rate in a recent study, improving patient care.

Keywords:
anesthesiainfantinterventionalneonateradiology

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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.