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Risk for Blood Clots Increased With PICC Placement in Children

CLABSI, CVC malfunction risks also up for PICCs versus tunneled lines in children

TUESDAY, Jan. 7, 2020 (HealthDay News) — 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 Jan. 7 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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