title: Peripherally inserted central catheters: a randomized, controlled, prospective trial in pediatric surgical patients.
abstract: Peripherally-inserted central catheters (PICCs) are long-term IV catheters used for drug and fluid administration, blood sampling, or hyperalimentation. The short-term use of PICCs in postoperative patients has not been studied. In this randomized, controlled trial, patients received either a PICC or peripheral IV catheter (PIV). Our outcome measures were patient and parent satisfaction with care, complications of the venous access devices, number of postoperative venipunctures, and cost-effectiveness of use. Satisfaction was significantly more frequent in the PICC group (P < 0.05), and there were significantly fewer postoperative needle punctures in the PICC group compared with the PIV group (P < 0.05). Minor complications were common in the PIV group; major complications were uncommon in both groups. PICCs are more expensive, but better satisfaction can make them a cost-effective option. Additionally, insertion during surgical preparation time in the operating room (OR) means that cost is not increased by adding anesthesiologist and OR time. Anesthesiologists should consider placing PICCs in patients requiring more than 4 days of in-hospital postoperative care, especially if frequent blood sampling or IV access is required.
authors.affiliation: *Departments of Anesthesiology and Critical Care Medicine, Surgery, and Pediatrics, The Johns Hopkins University School of Medicine; and †Department of Biostatistics, The Johns Hopkins University School of Public Health, Baltimore, Maryland.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Schwengel
authors.forename: John
authors.initials: J
authors.lastname: McGready
authors.forename: Sean M
authors.initials: SM
authors.lastname: Berenholtz
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Kozlowski
authors.forename: David G
authors.initials: DG
authors.lastname: Nichols
authors.forename: Myron
authors.initials: M
authors.lastname: Yaster
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007432:Intraoperative Period; D008297:Male; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000191:economics; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies