A comparison of Broviac® and peripherally inserted central catheters in children with intestinal failure

Published:February 04, 2017DOI:https://doi.org/10.1016/j.jpedsurg.2017.01.036

      Abstract

      Purpose

      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 (0.1–16 years) 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.

      Conclusion

      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.

      Level of evidence

      11b (Prognosis Study).

      Abbreviation:

      IF (intestinal failure), PN (parenteral nutrition), CVC (central venous catheter), PICC (peripherally inserted central catheter), CLABSI (central line-associated bloodstream infection), CVT (central venous thrombosis)

      Key words

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