title: Are cuffed peripherally inserted central catheters superior to uncuffed peripherally inserted central catheters? A retrospective review in a tertiary pediatric center.
abstract: OBJECTIVE
  To assess the use of cuffed peripherally inserted central catheters (PICCs) compared with uncuffed PICCs in children with respect to their ability to provide access until the end of therapy.
  
  
  METHODS
  A retrospective review of PICCs inserted between January 2007 and December 2008 was conducted. Data collected from electronic records included patient age, referring service, clinical diagnosis, inserting team (pediatric interventional radiologists or neonatal intensive care unit [NICU] nurse-led PICC team), insertion site, dates of insertion and removal, reasons for removal, and need for a new catheter insertion. A separate subset analysis of the NICU population was performed. Primary outcome measured was the ability of the PICCs to provide access until the end of therapy.
  
  
  RESULTS
  Cuffed PICCs (n = 1,201) were significantly more likely to provide access until the end of therapy than uncuffed PICCs (n = 303) (P = .0002). Catheter removal before reaching the end of therapy with requirement of placement of a new PICC occurred in 26% (n = 311) of cuffed PICCs and 38% (n = 114) of uncuffed PICCs. Uncuffed PICCs had a significantly higher incidence of infections per 1,000 catheter days (P = .023), malposition (P = .023), and thrombus formation (P = .022). In the NICU subset analysis, cuffed PICCs had a higher chance of reaching end of therapy, but this was not statistically significant.
  
  
  CONCLUSIONS
  In this pediatric population, cuffed PICCs were more likely to provide access until the end of therapy. Cuffed PICCs were associated with lower rates of catheter infection, malposition, and thrombosis than uncuffed PICCs.
authors: Division of Interventional Radiology, Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada. hwtoh@hotmail.com
authors: Luke M H W
authors: LM
authors: Toh
authors: Ertugrul
authors: E
authors: Mavili
authors: Rahim
authors: R
authors: Moineddin
authors: Joao
authors: J
authors: Amaral
authors: Philip R
authors: PR
authors: John
authors: Michael J
authors: MJ
authors: Temple
authors: Dimitri
authors: D
authors: Parra
authors: Bairbre L
authors: BL
authors: Connolly
mesh_terms: D000293:Adolescent; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000706:statistics & numerical data*; D062905:Central Venous Catheters / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure / Q000706:statistics & numerical data*; D019544:Equipment Failure Analysis; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: CVC; NICU; PICC; VAS; Vascular Access Service; central venous catheter; neonatal intensive care unit; peripherally inserted central catheter