Peripherally inserted central catheters: use at a tertiary care pediatric center

J Vasc Interv Radiol. 2013 Sep;24(9):1323-31. doi: 10.1016/j.jvir.2013.04.010. Epub 2013 Jul 19.


Purpose: To examine the use of peripherally inserted central catheters (PICCs) in a tertiary care pediatric setting.

Materials and methods: An observational study of use and referral practices for PICCs in a tertiary care pediatric setting was performed with three distinct approaches: (i) in an institutional overview of trends, data from 2001 to 2012 were initially analyzed to identify high-level trends; (ii) an in-depth analysis of PICC referrals during 1 year was performed to determine details of referral patterns and clinical practices; and (iii) an electronic survey of the perception and understanding of referring clinical staff was conducted.

Results: During the past decade, there has been a steady increase in the number of PICC insertions and a decrease in median PICC dwell times. Discrepancies were identified between the anticipated versus actual dwell times. A large proportion of patients was found to have multiple PICC insertions, short dwell times, and premature PICC removals, potentially resulting in increasing risks of short- and long-term complications. Large percentages of the staff respondents valued the role of PICCs and had a good understanding of short-term complications, but underestimated the scale of the PICC service (numbers placed, resources involved) and several long-term complications associated with PICCs.

Conclusions: The number of PICCs inserted in children is increasing while PICC dwell times are decreasing. Better postprocedure care is important to minimize premature removals and avoid repeat insertions. Associated complications are not fully appreciated by the referring pediatricians. Further education and guidelines are needed.

Keywords: PICC; TPN; peripherally inserted central catheter; total parenteral nutrition.

MeSH terms

  • Adolescent
  • Attitude of Health Personnel*
  • Catheter-Related Infections / epidemiology*
  • Catheterization, Central Venous / statistics & numerical data*
  • Catheterization, Central Venous / trends
  • Child
  • Child, Preschool
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Medical Audit
  • Ontario / epidemiology
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends
  • Pregnancy
  • Referral and Consultation / statistics & numerical data*
  • Referral and Consultation / trends
  • Retrospective Studies
  • Risk Assessment
  • Tertiary Healthcare / statistics & numerical data
  • Tertiary Healthcare / trends
  • Utilization Review