skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair

Abstract

IntroductionPreservation of venous access in children is a major concern in pediatric interventional radiology. If a peripherally inserted central catheter (PICC) breaks, there are two options: repair the line with a repair kit or exchange the line over a wire in the interventional suite. The purpose of this study is to assess the outcome of PICC repairs in children and to compare these with the outcomes of PICC exchange.Materials and MethodsThis is a single-center, retrospective study of central line-associated bloodstream infection (CLABSI) following management of externally broken PICCs (2010–2014). The occurrence of CLABSI within 30 days after repair (Group A) or exchange (Group B) of a line was analyzed, as well as PICCs exchanged following an initial and failed repair.ResultsA total of 235 PICC breaks were included in the study, of which 161 were repaired, and 116 of whom were successful (68%, Group A). No repair was performed in 74 PICCs—55/74 of these were exchanged over a wire (74%, Group B), and 19/74 lines were removed. The 30 days post-repair CLABSI rate (Group A) was 2.0 infections per 1000 catheter days, and the calculated risk was 4.3%. In comparison the 30 days post-exchange CLABSI rate (Group B) was 4.0 per 1000 catheter daysmore » and the calculated risk 10.9%. This difference was significant when adjusted for antibiotic use (OR 3.87; 95% CI 1.07–14.0, p = 0.039).ConclusionThe results of this study support repairing a broken PICC instead of removing or replacing the line.« less

Authors:
; ; ; ; ; ;  [1];  [2];  [1]
  1. University of Toronto, Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children (Canada)
  2. University of Toronto, Child Health Evaluative Sciences (Canada)
Publication Date:
OSTI Identifier:
22645178
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 6; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIBIOTICS; BIOMEDICAL RADIOGRAPHY; CHILDREN; COMPARATIVE EVALUATIONS; HAZARDS; PATIENTS; PEDIATRICS; REPAIR; VASCULAR DISEASES; WIRES

Citation Formats

Gnannt, Ralph, E-mail: ralph.gnannt@usz.ch, Patel, Premal, Temple, Michael, Al Brashdi, Yahya, Amaral, Joao, Parra, Dimitri, Rea, Vanessa, Stephens, Derek, and Connolly, Bairbre. Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1580-X.
Gnannt, Ralph, E-mail: ralph.gnannt@usz.ch, Patel, Premal, Temple, Michael, Al Brashdi, Yahya, Amaral, Joao, Parra, Dimitri, Rea, Vanessa, Stephens, Derek, & Connolly, Bairbre. Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair. United States. doi:10.1007/S00270-017-1580-X.
Gnannt, Ralph, E-mail: ralph.gnannt@usz.ch, Patel, Premal, Temple, Michael, Al Brashdi, Yahya, Amaral, Joao, Parra, Dimitri, Rea, Vanessa, Stephens, Derek, and Connolly, Bairbre. Thu . "Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair". United States. doi:10.1007/S00270-017-1580-X.
@article{osti_22645178,
title = {Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair},
author = {Gnannt, Ralph, E-mail: ralph.gnannt@usz.ch and Patel, Premal and Temple, Michael and Al Brashdi, Yahya and Amaral, Joao and Parra, Dimitri and Rea, Vanessa and Stephens, Derek and Connolly, Bairbre},
abstractNote = {IntroductionPreservation of venous access in children is a major concern in pediatric interventional radiology. If a peripherally inserted central catheter (PICC) breaks, there are two options: repair the line with a repair kit or exchange the line over a wire in the interventional suite. The purpose of this study is to assess the outcome of PICC repairs in children and to compare these with the outcomes of PICC exchange.Materials and MethodsThis is a single-center, retrospective study of central line-associated bloodstream infection (CLABSI) following management of externally broken PICCs (2010–2014). The occurrence of CLABSI within 30 days after repair (Group A) or exchange (Group B) of a line was analyzed, as well as PICCs exchanged following an initial and failed repair.ResultsA total of 235 PICC breaks were included in the study, of which 161 were repaired, and 116 of whom were successful (68%, Group A). No repair was performed in 74 PICCs—55/74 of these were exchanged over a wire (74%, Group B), and 19/74 lines were removed. The 30 days post-repair CLABSI rate (Group A) was 2.0 infections per 1000 catheter days, and the calculated risk was 4.3%. In comparison the 30 days post-exchange CLABSI rate (Group B) was 4.0 per 1000 catheter days and the calculated risk 10.9%. This difference was significant when adjusted for antibiotic use (OR 3.87; 95% CI 1.07–14.0, p = 0.039).ConclusionThe results of this study support repairing a broken PICC instead of removing or replacing the line.},
doi = {10.1007/S00270-017-1580-X},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 40,
place = {United States},
year = {Thu Jun 15 00:00:00 EDT 2017},
month = {Thu Jun 15 00:00:00 EDT 2017}
}