A comparison of Broviac®and peripherally inserted central catheters in children with intestinal failure.
OBJECTIVE
Central venous catheters (CVCs) are a source of morbidity for children with intestinal failure (IF). Complications include infection, breakage, occlusion, and venous thrombosis. Broviacs® have traditionally been preferred, but peripherally inserted central catheters (PICCs) are gaining popularity. This study compares complications between Broviacs® and PICCs in children with IF.


METHODS
After IRB approval, children with IF receiving parenteral nutrition (2012-2016) were reviewed. Complications were compared between Broviacs® and PICCs using the generalized estimation equation population-averaged Poisson regression model. P values <0.05 were considered significant.


RESULTS
36 children (0.1-16years) with IF were reviewed, accounting for 27,331 catheter days, 108 Broviacs® (3F-9F), and 54 PICCs (2-11F). Broviacs® had a significantly higher infection rate (4.2 vs. 2.6/1000 catheter days, p=0.011), but PICCs were more likely to break (1.56 vs. 0.26/1000 catheter days, p=0.002). When comparing same size catheters (3F), there were no significant differences in infection, breakage, or occlusion. Twelve children (33%) had central venous thrombosis, all after Broviac® placement. Three children (8%) had basilic vein thrombosis after PICC placement.


CONCLUSIONS
Although Broviacs® and PICCs had similar complication rates, there were fewer central venous thromboses associated with PICCs. This should be considered when choosing catheters for children with IF.


METHODS
11b (Prognosis Study).
Texas Tech University Health Science Center, Paul L. Foster School of Medicine, El Paso, TX, USA.
Carolina
C
Blotte
Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Jennifer
J
Styers
Division of Biostatistics, University of Texas Southwestern, Dallas, TX, USA.
Hong
H
Zhu
Division of Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Nandini
N
Channabasappa
Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, USA. Electronic address: hannah.piper@childrens.com.
Hannah G
HG
Piper
D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000628:therapy*; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies
Central venous catheter; Complications; Intestinal failure; Peripherally inserted central catheter