PERIPHERALLY INSERTED CENTRAL CATHETERS - EXPERIENCE IN 523 CHILDREN

PURPOSE: To evaluate prospectively the use of peripherally inserted ce ntral catheters in a large pediatric population. MATERIALS AND METHODS : During a 3-year period, data were collected prospectively on 523 con secutive attempts to place peripherally inserted central catheters in children. Patients underwent radiologically guided placement because a ttempts were unsuccessful on the inpatient units or a patient request was made. Fluoroscopy with use of contrast material and venography wer e used to place catheters and document the position of the catheter ti p. Followup data were collected until treatment cessation or catheter removal. RESULTS: Among 523 attempts, 486 (92.9%) catheters were succe ssfully placed. In the 37 (7.1%) unsuccessful cases, more than half of these children were younger than 24 months of age or weighed less tha n 5 kg. Ages of patients in whom 523 placement attempts were made rang ed from 3 weeks to 18 years (mean, 6.9 years). Catheters were in place from 1 to 390 days (mean, 20 days). Frequency of infection was 1.9% ( nine cases); incidence of infection was 0.93 per 1,000 catheter-placem ent days. There were two cases (0.4%) of central venous thrombosis. Mo st patients were discharged within 2 days of catheter placement. CONCL USION: Fluoroscopically guided placement of peripherally inserted cent ral catheters is a safe and effective method for establishing intermed iate-and long-term central venous access in the pediatric population.