TUNNELED ADULT PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) FOR CENTRAL VENOUS ACCESS IN PAEDIATRICS: A SINGLE CENTRE EXPERIENCE.
Nurul Nabila Mortadza, Arvin Rajadurai, Norhafizah Ehsan, Ganesan Arthimulam, Noorshahrizal Nordin, Zulkifli Zaki Abdul Ghani
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Objective: Long term intravenous access in paediatrics is challenging in terms of ease of procedure, maintenance of catheter and complications. Small calibre of peripheral veins in children make insertion of peripheral long-term access difficult. Our centre adopted the use of tunneled adult Peripherally Inserted Central Catheter (PICC) for central venous access in paediatrics with the hope to improve these challenges. We describe a single institute 3-year experience of this technique. Material & Methods: Retrospective analysis of patients aged less than 12 years old who had tunneled PICC insertions from January 2018 till December 2020. The following data was recorded and studied: indication, reason for removal, duration of PICC, vessel inserted, device type and complications. Results: Eleven adult PICCs were inserted from this technique in 10 children. The average age was 35.7months and weight was 13.2kg. The youngest patient was 3 months old at 6.9kg. Most common indication for insertion was for long term antibiotics (82%) and the remainder were for difficult intravenous access. The procedure was done under local anaesthetic with sedation in 90% of cases. Average duration of PICC was 26.8 days. Out of 11 PICCs only 1 had line related infection that required premature removal of the catheter. 55% completed the intended duration while 27% of PICCs had dislodged. Conclusion: Tunnelled adult PICC for central venous access in paediatrics is a feasible option for long term vascular access and has a lower risk of infection. However, almost a third of the catheters inserted still suffered premature dislodgement.