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Long peripheral catheters in children: A scoping review
Alina G Burek1,2, Tracey Liljestrom1,2, Melanie Dundon1,2
1Children's Wisconsin, Milwaukee, Wisconsin, USA.
Insights
Long peripheral catheters (LPCs) show promise for pediatric vascular access, offering longer dwell times than peripheral intravenous catheters (PIVs). Further research is needed to establish optimal use and safety in children.
Area of Science:
- Pediatric vascular access devices
- Medical device effectiveness and safety
- Evidence synthesis and scoping reviews
Background:
- Long peripheral catheters (LPCs) are emerging devices for short-to-medium term vascular access.
- Adult data suggest LPCs offer longer dwell times than peripheral intravenous catheters (PIVs) and fewer complications than peripherally inserted central catheters (PICCs).
- The role and safety of LPCs in pediatric populations remain less established.
Purpose of the Study:
- To conduct a scoping review of the existing literature on the effectiveness and safety of LPCs in pediatric patients.
- To synthesize current evidence regarding LPC use in children.
- To identify gaps in knowledge for future research.
Main Methods:
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.
- Comprehensive literature searches across multiple databases (MEDLINE, CENTRAL, Web of Science, Scopus, CINAHL, Google Scholar) up to February 2022.
- Inclusion criteria: English language, published from 2000 onwards, patients under 18 years of age.
Main Results:
- Twenty-one studies were included, exhibiting variability in quality and outcomes.
- Median dwell times for LPCs ranged from 5 to 14 days.
- Common complications included dislodgement, occlusion, and infiltration (0%-31%); venous thromboembolism rates were 0%-13%. Catheter-related bloodstream infection rates were low (0% in 9/10 studies).
- Therapy completion rates varied widely (20%-86%).
Conclusions:
- Long peripheral catheters demonstrate potential benefits in pediatric populations, including extended dwell times compared to PIVs.
- LPCs may offer a safer alternative to PICCs regarding serious complications, though further evidence is required.
- Additional research is necessary to define optimal utilization and safety profiles of LPCs in pediatric care.
Background And Objectives:
Long peripheral catheters (LPCs) are emerging vascular access devices used for short-medium term vascular access needs. Literature in adults suggests LPCs have longer dwell-times than peripheral intravenous catheters (PIVs) and lower rates of serious complications than peripherally inserted central catheters (PICCs). The role of LPCs in children is less established. The objective of this scoping review is to describe and synthesize the existing literature on the effectiveness and safety of LPCs in children.
Methods:
This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches were done in MEDLINE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science Core Collection, Scopus, CINAHL (Ebsco), and Google Scholar most recently on February 22, 2022. Studies were included if published in English on or after 2000 and included patients <18 years of age.
Results:
Twenty-one studies were included. The body of literature is variable in quality, measurements, and reported outcomes. Median dwell-time ranged from 5 to 14 days. The rate of completion of therapy ranged from 20% to 86%. Dislodgement, occlusion, and infiltration were the most common complications reported (0%-31%). Venous thromboembolism rates ranged from 0% to 13%. The rate of catheter-related bloodstream infection was 0% in 9 of 10 studies. Less than 50% of studies reported comparative outcomes.
Conclusion:
LPCs show promising outcomes in select populations, with longer dwell-time than PIVs and possibly lower rates of serious complications than PICCs. However, more research is needed to clarify the optimal use of LPCs in pediatrics.
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