title: Sutured securement of peripherally inserted central catheters yields fewer complications in pediatric patients.
abstract: BACKGROUND
  Pediatric peripherally inserted central catheters (PICCs) can be secured with tape, sutures, or sutureless securement devices. Despite widespread catheter use, no standardized method of securement has been proven superior.
  
  
  METHODS
  A prospective randomized trial of catheter securement with either tape or suture was undertaken in pediatric patients hospitalized at a tertiary children's hospital. Patient demographics, catheter dwell time, and all catheter complications were collected. All patients were followed for the entire dwell time of the catheter, including those discharged with lines still in place.
  
  
  RESULTS
  Sixty-six patients completed the study, with 34 children in the suture group and 32 children in the tape group. Patients' ages ranged from 9 months to 19 years. Overall complication rate in our sutured group was 5.8%, and 32.4% in the tape group.
  
  
  CONCLUSIONS
  In this study of children of varying ages, sutured PICCs were associated with significantly fewer complications than those catheters secured with tape (p=.005). The 3 most common complications included migration, occlusion, and leaking catheters.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Section of Intensive Care, Texas Children's Hospital, Houston, Texas 77030, USA. jgraf@bcm.edu
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Graf
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Newman
authors.forename: Mona L
authors.initials: ML
authors.lastname: McPherson
mesh_terms: D000293:Adolescent; D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D053832:Surgical Tape / Q000706:statistics & numerical data*; D013536:Suture Techniques / Q000706:statistics & numerical data*; D016896:Treatment Outcome