Journal article
Use and Outcomes of Peripherally Inserted Central Catheters in Hospitalized Infants
Hospital pediatrics, Vol.15(9), pp.748-757
09/01/2025
DOI: 10.1542/hpeds.2024-008246
PMID: 40763931
Abstract
The optimal strategy to prevent catheter-related thrombosis (CRT) in children remains unclear. We aimed to characterize the appropriateness of peripherally inserted central catheters (PICCs) in hospitalized infants and to explore the feasibility of a randomized clinical trial (RCT) of antiplatelet therapy to prevent CRT in these infants.
We conducted a multicenter retrospective cohort study of hospitalized infants younger than 1 year who had a PICC inserted between January 2017 and December 2020. We collected infant and PICC-related data from electronic medical records. Appropriateness of PICCs was assessed using the Michigan Appropriateness Guide for Intravenous Catheters in Pediatrics guidelines. Feasibility of the RCT was assessed based on frequency of CRT and availability of patients.
A total of 434 infants were studied. Median age was 17 days (IQR: 4, 96 days). Of these, 153 (35.3%) infants were at risk of bleeding with antiplatelet therapy, whereas 103 (23.7%) were nil per os, including medications. PICCs were considered appropriate in 257 (82.6%) infants. Proportions of appropriate PICCs were lower in PICCs with durations of 0 to 7 days (60.6%) and in infants older than 30 days (74.0%) or not admitted to the intensive care unit (75.6%). CRT occurred in 22 (5.1%) infants or 2.2 cases (95% CI: 1.2-4.1 cases) per 1000 PICC-days. CRT was associated with elevated mean platelet volume (risk ratio: 3.14, 95% CI: 1.68-5.84).
Opportunities exist to reduce the number of PICCs inserted in hospitalized infants. An RCT of antiplatelet therapy to prevent CRT may be challenging.
Details
- Title: Subtitle
- Use and Outcomes of Peripherally Inserted Central Catheters in Hospitalized Infants
- Creators
- Madhuradhar Chegondi - University of IowaManette Ness-Cochinwala - Robert Wood Johnson University HospitalHilary Schreiber - Children's Hospital of WisconsinMatthew Pinto - Maria Fareri Children's HospitalLee A Polikoff - Hasbro Children's HospitalHarsh Kothari - Dayton Children's HospitalJodi Bloxham - University of IowaSantosh Kaipa - University of Nebraska at OmahaAbigail Bergman-Sieger - Robert Wood Johnson University HospitalBethany Mancuso - Robert Wood Johnson University HospitalTyler Harder - Brown UniversitySarah Korn - Maria Fareri Children's HospitalCheryl Gillette - Golisano Children's HospitalEileen Taillie - University of RochesterJill Cholette - University of RochesterElizabeth Kerris - Penn State Milton S. Hershey Medical CenterRachel Johnson - Yale UniversityE Vincent S Faustino - Yale University
- Resource Type
- Journal article
- Publication Details
- Hospital pediatrics, Vol.15(9), pp.748-757
- DOI
- 10.1542/hpeds.2024-008246
- PMID
- 40763931
- NLM abbreviation
- Hosp Pediatr
- ISSN
- 2154-1663
- eISSN
- 2154-1671
- Language
- English
- Electronic publication date
- 08/06/2025
- Date published
- 09/01/2025
- Academic Unit
- Stead Family Department of Pediatrics; Nursing
- Record Identifier
- 9984945090102771
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