Abstract:

objective: To examine the use of peripherally inserted central catheters（PICCs） in a tertiary pediatric setting. Methods: The recruited patients with PICC line for intermediate- to long- term fluid infusion were collected from the Pulmonology and Gastroenterology Departments of Children's Hospital of Fudan University from Dec. 2015 to Feb. 2017. Data of indications, complications, efficacy of PICC and reasons for catheter removal were collected and analyzed. Results: 60 cases with PICC insertions（1 case was a child with PICC contraindication） were included in the analysis. There were 38 male cases and 22 female cases with age of 34 days to 14 years. The indications for PICC insertion included long-term parenteral nutrition(45/60, 75.0%),expected long-term（＞6 days）intravenous medication infusion（9/60, 15.0%）and insufficiency of peripheral venous access（6/60, 10%）.Catheter indwelling time was （17.2±10.7）d, while total indwelling time was 1 033 catheter days. Complications occurred in 22 cases（22.3/1000 catheter days）, including 7 malposition, 6 catheter blockage, 3 phlebitis, 3 catheter breakage, 2 arterial puncture, 1 vasospasm, 1 case of failing venous reflux. 42 cases（70%） were planned on catheter removal，while 5 cases（8.3%） were unplanned on catheter removal, 13 cases（21.7%）were transferred to the other ward or discharged with the catheter. The average PICC procedure time was (68.2±43.5)min, and catheterrelated expenditure/hospitalization expenditure ratio was 0.07. Conclusion: As an applicable venous access, PICCs provide convenience in patients requiring intermediate- to long- term intravenous infusion. Meticulous post procedure care is important for minimizing unexpected line removal and catheter related complications.