Infant PICC placement without general anesthesia

"Infants younger than 6 months and under 5.5 kg can be managed without general anesthesia for peripherally inserted central catheterinsertion using a Fast, Feed and Wrap technique" Laing et al (2020).

Abstract:

Background: Avoiding anesthesia for infantperipherally inserted central catheter insertion beyond the neonatal period has been the subject of very little research despite this being a high risk age group. In our institution we introduced a “Fast, Feed and Wrap” technique,previously described for magnetic resonance imaging scans,for infantsup to 6 months and weighing under 5.5 kg undergoing peripherally inserted central catheter insertion.

Aims: The aimwas toreport our experience using “Fast, Feed and Wrap”, in particular the success rate and proportion of qualifying infants who were managed this way.

Methods: A retrospective study was undertakenusing electronic records and case notes to determine patient age, weight, indication for procedure, anesthetic technique (general anesthesia or “Fast, Feed and Wrap”), peripherally inserted central catheter details (site of insertion, gauge and number of lumens) and length of procedure.

Results: 51infants qualified for “Fast, Feed and Wrap” over a 42 month period, 43 were attempted this way and 40 were successful. All infants were greater than 40 weeks post conceptual age at the time of peripherally inserted central catheter insertion under “Fast, Feed and Wrap”, though 26% were preterm. The average age of babies undergoing “Fast, Feed and Wrap” was35 days (IQR 18-55)and the median weight was 3.78kg (IQR 3.48-4.77).

Conclusions: Infants younger than 6 months and under 5.5 kg can be managed without general anesthesia for peripherally inserted central catheterinsertion using a Fast, Feed and Wrap technique.

Reference:

Laing, S., Burgoyne, L. L., Muncaster, M., Taranath, A. and Taverner, F. J. (2020) Infant peripherally inserted central catheter insertion without general anesthesia. Paediatric Anaesthesia. June 18th. https://doi.org/10.1111/pan.13950. (epub ahead of print).

Safety IV catheter