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Published on: September 18, 2013
Peripherally inserted central venous catheter for pediatric acute leukemia: A retrospective 11-year single-center
Silvio Ligia1, Salvatore Giacomo Morano1, Francesca Kaiser1
1Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Insights
Peripherally inserted central catheters (PICCs) are safe and effective for long-term intravenous access in pediatric acute leukemia patients. A dedicated team ensures reliable use, despite potential complications like infections and thrombosis.
Area of Science:
- Pediatric Hematology
- Vascular Access Devices
- Oncology
Background:
- Peripherally inserted central catheters (PICCs) are increasingly used in pediatric oncology.
- PICC insertion in oncologic patients carries risks like thrombosis, mechanical issues, and infections.
- Limited data exist on long-term PICC use in pediatric patients with severe hematologic diseases.
Purpose of the Study:
- To evaluate the safety and efficacy of PICCs in pediatric patients with acute leukemia.
- To assess complication rates and dwell times for PICCs in this population.
Main Methods:
- Retrospective analysis of 196 PICCs inserted in 129 pediatric patients with acute leukemia.
- Data collected from the Pediatric Hematology Unit, Sapienza University of Rome.
Main Results:
- Median PICC dwell time was 190 days.
- Overall complication rate was 34%, including catheter-related bloodstream infections (22%), catheter-related thrombosis (3.5%), and mechanical complications (9%).
- Premature removal due to complications occurred in 30% of cases; one death from CRBSI was reported.
Conclusions:
- PICC is a cost-effective, safe, and reliable device for long-term intravenous access in children with acute leukemia.
- A dedicated PICC team is crucial for successful implementation.
- This study represents the largest cohort of pediatric acute leukemia patients with PICC use.
Background:
Peripherally inserted central catheters (PICCs) are successfully increasingly used in children in onco-hematologic setting. PICC insertion, especially in oncologic patients, can be associated with adverse events (thrombosis, mechanical complications, and infections). Data regarding the use of PICC, as long-term access in pediatric patients with severe hematologic diseases, are still limited.
Methods:
We retrospectively evaluated the safety and efficacy of 196 PICC, inserted in 129 pediatric patients with acute leukemia diagnosed and treated at Pediatric Hematology Unit, Sapienza University of Rome.
Results:
The 196 PICC analyzed were in situ for a median dwell time of 190 days (range 12-898). In 42 children, PICC was inserted twice and in 10, three times or more due to hematopoietic stem cell transplant, disease recurrence, or PICC-related complications. The overall complication rate was 34%: catheter-related bloodstream infections (CRBSI) occurred in 22% of cases after a median time of 97 days; a catheter-related thrombosis (CRT) in 3.5% and mechanical complications in 9% of cases. Premature removal for complications occurred in 30% of PICC. One death from CRBSI was observed.
Conclusions:
To our knowledge, this study represents the largest cohort of pediatric patients who have inserted the PICC for acute leukemia. In our experience, PICC was a cheap, safe, and reliable device for long-term intravenous access in children with acute leukemia. This has been possible with the help of dedicated PICC team.
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