Peripherally Inserted Central Catheters in Pediatric Patients Performed by Radiologists Using Fluoroscopy


( Last Updated : January 22, 2021)
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:
RC1330-000

Details


Question


  1. What is the comparative clinical effectiveness of peripherally inserted central catheter (PICC) insertions performed by radiologists in interventional radiology suites versus PICC insertions performed by nurses at the bedside/unit in pediatric patients?

  2. What are the evidence-based guidelines regarding the optimal approach for PICC insertions in pediatric patients?


Key Message

Evidence from 2 clinical studies showed that there was no difference in the rates of infection and complications between peripherally inserted central catheter (PICC) insertion at the bedside and insertion in Interventional Radiology (IR) suites. However, each of these studies focused on small subgroups of the larger pediatric population and had other methodological limitations. Evidence from 1 clinical study in a single quaternary, non-cardiac, pediatric intensive care unit suggested that the median time from PICC line order to successful insertion was longer for lines placed in the IR compared to at the bedside. Two guidelines with numerous quality limitations were identified that recommend ultrasound guidance for insertion of central venous access devices (CVAD), including PICCs: 1 was aimed at all pediatric patients and 1 was aimed at onco-hematological pediatric patients.