Risk for Blood Clots Increased With PICC Placement in Children

Central venous catheter (CVC) placement with peripherally inserted central catheters (PICCs) in children is associated with increased risks for venous thromboembolism (VTE), central line-associated bloodstream infection (CLABSI), and CVC malfunction, according to a study published online January in Blood.

Julie Jaffray, M.D., from the Children's Hospital Los Angeles, and colleagues enrolled patients aged 6 months to 18 years with newly placed PICCs or tunneled lines (TLs) and compared the incidence of VTE in a multicenter prospective, observational cohort study. Data were included for 1,967 CVCs placed in 1,742 unique individuals.

The researchers found that the incidence of catheter-related VTE was 5.9 ± 0.63 percent. Eighty percent of cases were in individuals with PICCs, which had a significantly higher risk for catheter-related VTE compared with TLs (hazard ratio, 8.5). Compared with those with TLs, patients with PICCs were also significantly more likely to have a CLABSI (hazard ratio, 1.6) and CVC malfunction (hazard ratio, 2.0). Patients with a prior history of VTE, multilumen CVC, and leukemia had an increased risk for CVC-related VTE (hazard ratios, 23. 3.9, and 3.5, respectively).

"Now we can say definitively that patients who have PICCs have a much higher rate of thrombosis as well as central line associated bloodstream infections and catheter malfunctions when compared to TLs," Jaffray said in a statement. "PICCs are not as benign as we once thought."

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