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"The PICC via an EJV approach without GA is a feasible and safe practice with acceptable success and complication rates, and low costs. It might be an attractive alternative for obtaining central vascular access for paediatric patients" Zhang et al (2023).
Non-conventional paediatric PICC placement

Abstract:

Purpose: This study aimed to describe a peripherally inserted central catheterisation (PICC) for paediatric patients with inaccessible access and a high risk of general anaesthesia (GA).

Methods: This was a retrospective observational study involving all paediatric inpatients who performed the PICC via an EJV approach without GA between September 2014 and September 2021 in a provincial key clinical speciality.

Results: A total of 290 EJV line placement attempts were performed, and 29 were excluded due to missing placement results, resulting in a sample size of 261. The anatomical localisation, punctures, and catheterisation success rates for this practice were 100%, 100%, and 90.04%, respectively. The placement success rate in children younger than one year was 93.75% (45/48). The median line duration of use was 19 days, with a median length of catheter insertion of 13 cm. The most common complications were catheter malposition (n = 20) and dislodgement (n = 7).

Conclusion: The PICC via an EJV approach without GA is a feasible and safe practice with acceptable success and complication rates, and low costs. It might be an attractive alternative for obtaining central vascular access for paediatric patients.

Reference:

Zhang P, Jia M, Li WY, Li J, Niu JL, Ding H, Zhou WM. Cannulation via the external jugular vein–An alternative to conventional peripherally inserted central catheterisation for paediatric patients. BMC Pediatr. 2023 Nov 18;23(1):579. doi: 10.1186/s12887-023-04403-5. PMID: 37980462.