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Complications associated with peripherally inserted central catheters in paediatric cardiac patients

Published online by Cambridge University Press:  09 February 2022

Jay R. Patel
Affiliation:
Department of Medical Education, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Shilpa Vellore Govardhan
Affiliation:
Department of Pediatrics, Division of Cardiology, University of California San Diego School of Medicine/Rady Children’s Hospital, San Diego, CA, USA
Pilar Anton-Martin*
Affiliation:
Department of Pediatrics, Division of Cardiology, University of Tennessee Health Science Center/Le Bonheur Children’s Hospital, Memphis, TN, USA
*
Author for correspondence: P. Anton-Martin, MD, PhD, Department of Pediatrics, Division of Cardiology, University of Tennessee Health Science Center/Le Bonheur Children’s Hospital, 49 N. Dunlap St., 3rd Floor, Memphis, TN 38103, USA. Tel: +1 901 287 6819; Fax: +901 287 5970. E-mail: pilarantonmartin@gmail.com

Abstract

Objectives:

To characterise the use of peripherally inserted central catheters in paediatric cardiac patients and to identify risk factors associated with their complications.

Materials and Methods:

Observational retrospective cohort study in paediatric cardiac patients who underwent peripherally inserted central catheter placement in a tertiary children’s hospital from January 2000 to June 2018.

Results:

1822 cardiac patients underwent 2952 peripherally inserted central catheter placements in the study period. Median age was 29 days, with survival to hospital discharge of 96.4%. Successful placement achieved 94.5% of attempts, with a median line duration of 12 days. Factors associated with successful placement were the use of general anaesthesia (odds ratio 7.52, p < 0.001) and year of placement (odds ratio 1.08, p < 0.001). The incidence of complications was 28.6%, with thrombosis/occlusion being the most frequent (33%). Thrombosis/occlusion were associated with two and three lumens (odds ratio 1.96, p < 0.001 and 4.63, p = 0.037, respectively). Lines placed by interventional radiology had decreased infiltration (odds ratio 0.20, p = 0.002) and lower migration/malposition (odds ratio 0.36, p < 0.001). The use of maintenance intravenous fluids (odds ratio 3.98, p = 0.008) and peripheral tip position (odds ratio 3.82, p = 0.001) were associated with increased infiltration. The probability of infection decreased over time (odds ratio 0.79, p < 0.001).

Conclusion:

Peripherally inserted central catheters in paediatric cardiac patients have complication rates similar to other paediatric populations. A prospective assessment of the factors associated with their complications in this patient population may be beneficial in improving outcomes.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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