Increased risk of symptomatic upper-extremity venous thrombosis with multiple peripherally inserted central catheter insertions in pediatric patients

Pediatric Radiology
Ralph GnanntBairbre Connolly

Abstract

Peripherally inserted central catheters (PICCs) are associated with superficial and deep venous thrombosis of the arm. The purpose of this study was to analyze the sequelae of repeated upper limb PICC insertions in children, in terms of the frequency of upper limb thrombosis in this patient group. The study population included all children who underwent their first successful arm PICC insertion between January 2010 and December 2015. We included subsequent ipsilateral arm PICCs in the analysis. Patients were followed until March 2016 or until any alternative central venous line insertion. For each PICC insertion, we collected demographic variables and line characteristics. We correlated all symptomatic deep and superficial thromboses of the arm with the PICC database. Applying inclusion and exclusion criteria, 2,180 PICCs remained for analysis. We identified first, second, third and fourth PICC insertions in the same arm in 1,955, 181, 38 and 6 patients, respectively. In total there were 57 upper body deep symptomatic thrombotic events. An increasing odds ratio was seen with higher numbers of PICC insertions, which was significant when comparing the first with the third and fourth PICC insertions in the same arm (odds ratio [OR...Continue Reading

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Citations

May 21, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Yoshiyuki ShimizuMuneyuki Takeuchi
Apr 23, 2019·JPEN. Journal of Parenteral and Enteral Nutrition·Kevin M BaskinUNKNOWN Venous Access: National Guideline and Registry Development (VANGUARD) Initiative Affected Persons Advisory Panel
Apr 1, 2019·Journal of Vascular and Interventional Radiology : JVIR·Ralph GnanntBairbre Connolly
Apr 6, 2021·International Journal of Clinical Practice·Juan WuHuan Liu
Jul 11, 2021·International Journal of Cardiology·Maria Cristina VedovatiCecilia Becattini

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