title: The efficacy and safety of blood sampling through peripherally inserted central catheter devices in children.
abstract: BACKGROUND
  The peripherally inserted central catheter (PICC) is commonly used in children for medication and fluid administration. In addition, PICCs are used occasionally for blood sampling as an alternative to venipuncture. Blood sampling from these catheters carries the hypothetical risk of catheter occlusion caused by blood remaining in the catheter, and this practice is not supported by PICC manufacturers. Children often undergo multiple needle punctures, which are associated with pain, anxiety, and dissatisfaction with care. The authors hypothesized that blood sampling through 3-Fr PICC devices is effective and safe for children.
  
  
  METHODS
  After placement of a 3-Fr PICC, all the children were sequentially enrolled in one of two groups. The control group included patients that had 3-Fr PICC devices without blood sampling. The blood sampling group included patients with 3-Fr PICC devices through which blood samples were obtained. Demographic data, PICC placement and sampling data, infusate composition, catheter occlusion, mechanical complications, and blood stream infections were recorded. The primary outcome variable was the difference in occlusion rates between the two groups.
  
  
  RESULTS
  The analysis included 204 children with 3-Fr PICCs (120 in the blood sampling group and 84 in the control group) who had a mean age, 117.7 +/- 4.9 months. The mean PICC duration was 15.6 +/- 1.0 days. Blood sampling was successful more than 98% of the time from all blood sampling group catheters, with a mean of 4.4 +/- 0.5 samples removed from each catheter. There was a higher occlusion rate in the blood sampling group. However, this result did not reach statistical significance. There were no significant differences between the groups in terms of infection or mechanical complication rates.
  
  
  CONCLUSIONS
  Blood sampling is feasible and effective through 3-Fr PICC devices in children. This practice is not associated with a significant increase in occlusion, infection, or mechanical complication rates.
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Knue
authors.forename: Darcy
authors.initials: D
authors.lastname: Doellman
authors.forename: Kim
authors.initials: K
authors.lastname: Rabin
authors.forename: Brian R
authors.initials: BR
authors.lastname: Jacobs
mesh_terms: D000367:Age Factors; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000295:instrumentation* / Q000451:nursing; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D015400:Clinical Nursing Research; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D004868:Equipment Failure; D005240:Feasibility Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009820:Ohio / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012449:Safety; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors