The results of this study support repairing a broken PICC instead of removing or replacing the line” Gnannt et al (2017).
Abstract:
INTRODUCTION: Preservation of venous access in children is a major concern in pediatric interventional radiology. If a peripherally inserted central catheter (PICC) breaks, there are two options: repair the line with a repair kit or exchange the line over a wire in the interventional suite. The purpose of this study is to assess the outcome of PICC repairs in children and to compare these with the outcomes of PICC exchange.
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MATERIALS AND METHODS: This is a single-center, retrospective study of central line-associated bloodstream infection (CLABSI) following management of externally broken PICCs (2010-2014). The occurrence of CLABSI within 30 days after repair (Group A) or exchange (Group B) of a line was analyzed, as well as PICCs exchanged following an initial and failed repair.
RESULTS: A total of 235 PICC breaks were included in the study, of which 161 were repaired, and 116 of whom were successful (68%, Group A). No repair was performed in 74 PICCs-55/74 of these were exchanged over a wire (74%, Group B), and 19/74 lines were removed. The 30 days post-repair CLABSI rate (Group A) was 2.0 infections per 1000 catheter days, and the calculated risk was 4.3%. In comparison the 30 days post-exchange CLABSI rate (Group B) was 4.0 per 1000 catheter days and the calculated risk 10.9%. This difference was significant when adjusted for antibiotic use (OR 3.87; 95% CI 1.07-14.0, p = 0.039).
CONCLUSION: The results of this study support repairing a broken PICC instead of removing or replacing the line.
Reference:
Gnannt, R., Patel, P., Temple, M., Al Brashdi, Y., Amaral, J., Parra, D., Rea, V., Stephens, D. and Connolly, B. (2017) Peripherally Inserted Central Catheters in Pediatric Patients: To Repair or Not Repair. Cardiovascular and Interventional Radiology. January 30th. [Epub ahead of print].
doi: 10.1007/s00270-017-1580-x.
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