Related Experiment Videos
Peripherally inserted central catheters in children
P G Chait1, J Ingram, C Phillips-Gordon
1Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Insights
Fluoroscopically guided peripherally inserted central catheters (PICCs) are a feasible and safe option for pediatric patients. This method showed a success rate comparable to blind insertion, with similar complication rates.
Area of Science:
- Pediatric Interventional Radiology
- Vascular Access Devices
- Medical Device Placement
Background:
- Peripherally inserted central catheters (PICCs) are crucial for long-term intravenous therapy in children.
- Assessing the safety and efficacy of image-guided PICC insertion is essential for pediatric care.
Purpose of the Study:
- To evaluate the feasibility and complication rates of fluoroscopically guided PICC placement in pediatric patients.
- To compare outcomes with established methods of PICC insertion.
Main Methods:
- 122 pediatric patients (9 days to 19 years) underwent fluoroscopically guided PICC insertion.
- Catheters were placed for antibiotic/chemotherapy, total parenteral nutrition, or prolonged IV access.
- Placement involved basilic or cephalic vein insertion, guided to the superior vena cava-right atrium junction.
Main Results:
- Successful PICC placement was achieved in 137 out of 148 attempts (92.6% success rate).
- Complications included mechanical defects, infection, occlusion, and venous stasis.
- The complication rate was comparable to blind insertion techniques.
Conclusions:
- Fluoroscopically guided PICC insertion is a feasible and safe procedure in the pediatric population.
- This technique offers a reliable method for establishing long-term central venous access in children.
Purpose:
To assess the feasibility and complications of peripherally inserted central catheters (PICCs) in pediatric patients.
Materials And Methods:
The authors attempted to place PICCs in 122 patients aged 9 days to 19 years (mean, 6.82 years; median, 5 years). Catheters were placed to allow prolonged administration of antibiotics or chemotherapeutic agents (n = 50), provide total parenteral nutrition (n = 41), and establish prolonged intravenous access for blood draws and fluid administration (n = 31). Silicone catheters measuring 3, 4, and 5 F were inserted in either basilic or cephalic veins and positioned at the junction of the superior vena cava and right atrium under fluoroscopic guidance. Patients were monitored for complications until devices were removed.
Results:
Fluoroscopically guided PICC placement was successful in 137 of 148 attempts. Postinsertion complications included mechanical defects of the catheter, PICC-related infection, occlusion of the PICC, and venous stasis. Complications occurred at a rate comparable to those seen with blind insertion.
Conclusion:
Fluoroscopically guided PICC placement is feasible and safe in pediatric patients.