The Outcomes of Peripherally Inserted Central Catheter (PICC) Insertion in Pediatric Patients at Siriraj Hospital

Abstract

Objective: Peripherally Inserted Central Catheters (PICC) are widely used for intermediate to long term venous access. Venipunctures and catheterizations in pediatric patients can be challenging and traumatizing to children’s veins due to frequent and painful needle sticks. This study aims to demonstrate the outcomes of PICC insertion and management in pediatric patients by the Anesthesia Line Service Team (ALiST) at Siriraj Hospital. Materials and Methods: This is a retrospective, descriptive study collecting data from January 2018 to December 2021. The inclusion criteria were pediatric patients aged 15 years and under, body weight equal to or exceeding 5 kg with no history of previous complicated central venous accesses. The primary outcome is the success rate of insertion.  Results: 124 PICCs were inserted in pediatric patients. The median age of patients was 5.0 years, with a median height of 107.8 cm, and a median weight of 10.0 kg. The successful insertion rate was 96.92%, and all insertions were inserted using ultrasound-guided technique, with or without fluoroscopy. No acute complications were noted during insertion. Most patients received either intravenous sedation (39.5%) or general anesthesia (26.6%) during the procedure. The mean duration of catheter indwelling was 66.48 days. Reasons for removal of PICC included completion of therapy and patient demise (70.97%), catheter malformation (8.06%), accidental removal (4.03%), infection (8.06%), and patient non-adherence (1.61%). Conclusion: Our research demonstrates a notably high rate of successful PICC placement among pediatric patients, with data indicating a minimal occurrence of complications and an extended duration of catheter usage.