title: Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure.
abstract: OBJECTIVE
  Infants with intestinal failure often require long-term central access for delivery of parenteral nutrition (PN). Traditionally, surgically placed central venous catheters (CVCs) have been used; however, the complications associated with these catheters can lead to significant morbidity. Peripherally inserted central catheters (PICCs) are potentially superior to CVCs because they tend to be smaller, and can be placed without general anesthesia. The purpose of the study is to report the use of PICCs for long-term administration of PN in infants with intestinal failure and compare with previously published catheter infection and venous thrombosis rates.
  
  
  METHODS
  A 4-year review of infants younger than 12 months with intestinal failure and a PICC for PN delivery was performed to determine the incidence of catheter-related bloodstream infections (CRBSIs) and PICC-associated venous thrombosis. The complication rates were compared with those reported for CVCs and PICCs in the pediatric literature.
  
  
  RESULTS
  A total of 45 infants with intestinal failure, receiving PN through a PICC were included in the study. Data from 95 PICCs accounting for 10,189 catheter days were collected. The overall incidence of CRBSI was 5.3/1000 catheter days and the incidence of venous thrombosis was 2.0/1000 catheter days.
  
  
  CONCLUSIONS
  PICCs offer an advantage over CVCs in that they can often be inserted without a general anesthesia and do not require manipulation of the vein. Given the low rate of CRBSI and venous thrombosis, we recommend PICCs for infants with intestinal failure requiring PN.
authors.affiliation: Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Piper
authors.forename: Nicole T
authors.initials: NT
authors.lastname: de Silva
authors.forename: Joao G
authors.initials: JG
authors.lastname: Amaral
authors.forename: Yaron
authors.initials: Y
authors.lastname: Avitzur
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D057785:Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000628:therapy*; D008297:Male; D010289:Parenteral Nutrition, Total / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*