Performance of Tunnelled, Noncuffed Central Venous Catheters and PICCs in Infants

Abstract

OBJECTIVE: To examine the performance of tunnelled, noncuffed central venous catheters and small-gauge peripherally inserted central catheters for infants. PATIENTS AND METHODS: Single-center, retrospective cohort study analyzing patient records for all patients younger than 12 months who had a tunnelled, noncuffed central venous catheter or small-gauge (≤3 Fr) peripherally inserted central catheter inserted at an Australian pediatric hospital over 4 years (2019-2022). RESULTS: A total of 267 catheters (107 tunnelled, noncuffed central venous catheters and 160 peripherally inserted central catheters) were examined, from device insertion to removal. Median age of infants was 58 days (IQR 86). A change in inserting clinicians' preferences for device selection over the study period was demonstrated, with increasing use of tunnelled, noncuffed central venous catheters. Of all devices, 65.2% (n = 174) were used until the end of prescribed treatment (104 peripherally inserted central catheters [65.0%] vs 70 tunnelled, noncuffed central venous catheters [65.4%]). Rates of central line-associated bloodstream infection (n = 7; 2.6%) and venous thrombosis (n = 5; 1.9%) were low. High rates of occlusion (overall [n = 115; 43.1%]; 76 peripherally inserted central catheters [47.5%] vs 39 tunnelled, noncuffed central venous catheters [36.4%]) and dislodgement (overall [n = 53; 19.8%]; 32 peripherally inserted central catheters [20.1%] vs 21 tunnelled, noncuffed central venous catheters [19.6%]) were evident. However, there is no indication of increased odds of occlusion between the device types. CONCLUSIONS: There was a change in clinician preference from peripherally inserted central catheters to tunnelled, noncuffed central venous catheters, and the removal rate due to complications was similar between devices.