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Anesth Analg 2004;99:1038-1043
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000132547.39180.88

PEDIATRIC ANESTHESIA

Peripherally Inserted Central Catheters: A Randomized, Controlled, Prospective Trial in Pediatric Surgical Patients

Deborah A. Schwengel, MD*, John McGready, MS{dagger}, Sean M. Berenholtz, MD MHS*, Lori J. Kozlowski, RN MS, CPNP*, David G. Nichols, MD MBA*, and Myron Yaster, MD*

*Departments of Anesthesiology and Critical Care Medicine, Surgery, and Pediatrics, The Johns Hopkins University School of Medicine; and {dagger}Department of Biostatistics, The Johns Hopkins University School of Public Health, Baltimore, Maryland

Address correspondence and reprint requests to Deborah A. Schwengel, MD, Blalock 904, The Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287. Address e-mail to dschweng{at}jhmi.edu

Peripherally-inserted central catheters (PICCs) are long-term IV catheters used for drug and fluid administration, blood sampling, or hyperalimentation. The short-term use of PICCs in postoperative patients has not been studied. In this randomized, controlled trial, patients received either a PICC or peripheral IV catheter (PIV). Our outcome measures were patient and parent satisfaction with care, complications of the venous access devices, number of postoperative venipunctures, and cost-effectiveness of use. Satisfaction was significantly more frequent in the PICC group (P < 0.05), and there were significantly fewer postoperative needle punctures in the PICC group compared with the PIV group (P < 0.05). Minor complications were common in the PIV group; major complications were uncommon in both groups. PICCs are more expensive, but better satisfaction can make them a cost-effective option. Additionally, insertion during surgical preparation time in the operating room (OR) means that cost is not increased by adding anesthesiologist and OR time. Anesthesiologists should consider placing PICCs in patients requiring more than 4 days of in-hospital postoperative care, especially if frequent blood sampling or IV access is required.

IMPLICATIONS: In this randomized, controlled trial, we found that peripherally inserted central catheters safely and effectively reduce needle punctures and improve patient satisfaction. The technique is cost-effective if anesthesiologists insert the catheters during surgical preparation time.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.