Abstract
#58 Changing the Outcome for the Pediatric Peripherally Inserted Central Catheter Patient:
Decreasing Occlusion Complications with the Implementation of an Alternative Peripherally Inserted Central Catheter
Abstract
• Peripherally Inserted Central Catheters
(PICCs) are commonly used in the pediatric
patient due to limited insertion sites, small
vessel sizes, and ease of use in the hospital
and home care setting.
• Catheter occlusion is a common complication
of PICCs and leads to delays in therapy,
premature catheter removal, and increased
costs. Additionally, the accumulation of fibrin
on the catheter surface intraluminally and
extraluminally is a nidus for catheter infection.
• Catheter occlusion is defined as the inability to
flush and /or aspirate the lumen or resistance
with flushing
• New technologies and catheter design have
emerged for reducing fibrin accumulation on
the catheter surface and backflow of blood.
This type of PICC was trialed at a large
pediatric teaching institution in the Midwest.
Objective
• To compare catheter occlusion rates in the
pediatric population between two types of PICCs.
Methods
• A single-center retrospective study was
completed over a 7-month period
• A total of 535 3 french PICCs were inserted
in patients by the pediatric vascular access
team including 263 standard non-valved
MedComp PICCs (Medical Components Inc,
Harleysville, PA) and 272 trial BioFlo™
PICCs with Endexo® and pressure activated
safety valve technology (Angiodynamics,
Latham, NY). Endexo® is a proprietary
polymer which is a permanent, non-eluting
and creates a catheter material which is
more resistant to the accumulation of blood
components (platelets and thrombus).
Pressure activated safety valve technology is
a valve that automatically resists backflow
and reduces blood reflux inside the catheter
(Lareu, Facchini, 2012).
• All PICCs were monitored by the vascular
access team. Catheter occlusion events
were entered as a complication in our
electronic medical record. Monthly reports on
PICC occlusions were reviewed.
Results
• This study demonstrated decreased occlusion
• Based on our data, we continue to use the
• Over the 7-month study period, the trial
PICC occlusion rate was 11.5%; the
standard PICC occlusion rate was
19.7%.
• An 8% decrease in catheter occlusions
were noted in the trial PICC group as
compared to the standard PICC group.
Conclusion
rates in 3 french PICCs in the trial group.
trial PICC and monitor patients daily for
mechanical and infectious complications.
References
Anderson, D.M., Pesaturo, K.A., Casavant, J., &
Ramsey, E.Z. (2013). Alteplase for the treatment of
catheter occlusion in pediatric patients. Ann
Pharmacother. Mar;47(3):405-9. doi:
10.1345/aph.1Q483.
Jumani, K., Advani, S., Reich, N.G., Gosey, L., &
Milstone, A.M. (2013). Risk factors for peripherally
inserted central catheter complications in children.
JAMA Pediatr. 67(5):429-435.
doi:10.1001/jamapediatrics.2013.775.
Lareau, R. & Facchini, F. (2012). A new option for
short or long term peripheral access to the central
venous system. White paper. Angiodynamics, Inc.
www.bioflopicc.com