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

Blotte, Carolina; Styers, Jennifer; Zhu, Hong; Channabasappa, Nandini; Piper, Hannah G.

doi:10.1016/j.jpedsurg.2017.01.036

Cited by 15 publications

(11 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although Broviacs® and PICCs had similar complication rates (infection, breakage, or occlusion), when comparing the same-size catheters (3F), there was less central venous thrombosis associated with PICCs. [17] Ultrasound-guided percutaneous central catheters can be a safe alternative in children but need skilled and experienced pediatric intensivists. [18] This may explain why the Broviac catheter was requested in an emergency in our study and why it was inserted in perioperative patients that would need venous access for a short period.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital

et al. 2022

View full text Add to dashboard Cite

Background: Hickman-Broviac catheters have improved the care of young children needing frequent and prolonged venous access, but at the same times it has substantial morbidity, particularly in a resource-constrained setup. Our study aims to describe the experience of a Tunisian hospital and investigate the main risk factors for complications. Methods: In this study, we included all the neonates and infants who underwent Broviac catheter insertion in the pediatric surgery department. The patients were divided into 2 groups according to the presence of complications. We compared these two groups and univariate logistic regression analyses were used to determine the risk factors for complications. Results: Forty-three children were included in the study. The incidence of complicated catheters was 60.4%. The following factors were significantly associated with an increased risk of complications: age 6 months [OR 3.5, 95% CI: 0.6-19.3], weight 6 kg [OR 1.54, 95% CI: 0.46-5.2], emergency circumstances [OR 1.62, 95% CI: 0.8-5.4], and antibiotic-therapy as an indication for Broviac catheter insertion [OR 1.8, 95% CI: 0.5-6.2]. Conclusion: Complications seem to be more frequent in patients younger than 6 months and those with a weight of less than 6Kg. To reduce the morbidity related to the catheters, the indications should be carefully chosen.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Despite the heterogeneity of reported populations, vessel preservation and complication prevention were the common themes when comparing PICC, short-and long-catheter PIVC, midline, tunneledcuffed CVAD, and totally implantable venous device indications. 16,32,90,109 Long-term PN Infusates CLABSI, occlusion, and thrombosis were common complications of longterm PN therapy across all VADs. 16,32 Peripheral devices (PIVCs and midlines) are unsafe for delivering PN because of the risk of venous damage 50,62,66 ; however, they may be indicated for limited time periods in hospitalized patients with restricted dextrose and protein concentrations (,10% and/or 5%, respectively).…”

Section: Congenital Cardiac Conditionsmentioning

confidence: 99%

“…16,32,90,109 Long-term PN Infusates CLABSI, occlusion, and thrombosis were common complications of longterm PN therapy across all VADs. 16,32 Peripheral devices (PIVCs and midlines) are unsafe for delivering PN because of the risk of venous damage 50,62,66 ; however, they may be indicated for limited time periods in hospitalized patients with restricted dextrose and protein concentrations (,10% and/or 5%, respectively). 66,76,107 One singlecenter observational study supported PICCs for long-term PN, 32 and another CPG recommended PICCs for home PN 107 ; although totally implantable venous devices were generally preferred when PN was required for long durations, despite being associated with an increased risk of infection.…”

Section: Congenital Cardiac Conditionsmentioning

confidence: 99%

“…66,76,107 One singlecenter observational study supported PICCs for long-term PN, 32 and another CPG recommended PICCs for home PN 107 ; although totally implantable venous devices were generally preferred when PN was required for long durations, despite being associated with an increased risk of infection. 16,29,32,50,56,92 Long-term Non-PN Infusates…”

Section: Congenital Cardiac Conditionsmentioning

confidence: 99%

See 1 more Smart Citation

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

View full text Add to dashboard Cite

OBJECTIVE: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). DATA SOURCES: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. STUDY SELECTION: Clinical practice guidelines, systematic reviews, cohort designs, randomized control trials (RCTs), quasi RCTs, before-after trials, or case-control studies that reported on complications and/or risk as well as reliability of VADs in patients aged 0 to 18 years were included. DATA EXTRACTION: Articles were independently reviewed to extract and summarize details on the number of patients and catheters, population, age of participants, VAD type, study method, indication, comparators, and the frequency of VAD failure or complications. RESULTS: VAD selection and insertion decision-making in general hospitalized and some specialized patient populations were well evidenced. The use of single-lumen devices and ultrasound-guided techniques was also broadly supported. There was a lack of RCTs, and for neonates, cardiac patients, patients with difficult venous access, midline catheters, catheter-tovein ratio, and near-infrared devices, the lack of evidence necessitated broadening the review scope. LIMITATIONS: Limitations include the lack of formal assessment of the quality of evidence and the lack of RCTs and systematic reviews. Consequently, clinical decision-making in certain pediatric populations is not guided by strong, evidence-based recommendations. CONCLUSIONS: This is the first synthesis of available evidence for the selection and insertion of VADs in pediatric patients and is important for determining the appropriateness of VADs in pediatric patients. WHAT'S KNOWN ON THIS SUBJECT: Individual studies, systematic reviews, and focused clinical practice guidelines that evaluate vascular access devices (VADs) in various pediatric populations are available. However, to date, no systematic review examining the appropriateness, and inappropriateness, of VADs across common pediatric clinical scenarios exists. WHAT THIS STUDY ADDS: There is strong evidence to support and facilitate appropriate clinical decision-making in some pediatric indications. However, certain populations, device types and characteristics, and insertion procedures are poorly evidenced, necessitating the application of clinical judgment for VAD decision-making.

show abstract

“…On the other hand, there are many institutions that use PICC devices for long-term paediatric venous access, and there are some data to support PICC devices having fewer complications than TCVCs. Blotte et al [ 13 ] carried out a retrospective analysis comparing the complications of Broviacs ® TCVC and PICCs in children with intestinal failure receiving parenteral nutrition. When comparing catheters with the same diameter, there were no significant differences in infection or breakage rates.…”

Section: Discussionmentioning

confidence: 99%

Adult ‘PICC’ Device May be Used as a Tunnelled Central Venous Catheter in Children

Lawson

Zealley

2018

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

PurposeCentral venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled central venous catheters (TCVCs) in children. The principal advantage of this novel technique is that the removal technique is less complex than that of conventional cuffed TCVCs. The catheter can be removed simply by being pulled out and does not require general anaesthesia. The purpose of this study is to determine the success, safety and utility of this technique and to identify the rate of late complications. We describe the 6-year experience in our unit.Materials and MethodsElectronic and paper medical records were reviewed for consecutive paediatric patients who had a PICC device inserted as a TCVC over a 6-year period (September 2009 through July 2015). The following data were recorded—patient demographics, setting for PICC as TCVC insertion, use of ultrasound and fluoroscopy, PICC device type, early or late complications and date of and reason for removal.ResultsTwenty-one PICCs were inserted as TCVCs in 19 children, all aged less than 10 years. Mean patient age at the time of placement was 3.7 years. Average patient weight was 15.7 kg. All insertions were successful with no significant immediate complications recorded. The most common indication for insertion in our patient sample was pseudo-obstruction secondary to gastrointestinal dysmotility disorder (24%), with cystic fibrosis infective exacerbation being the second most frequent diagnosis (14%). Suspected catheter-related infection led to early device removal in one case (4.8%). Inadvertent dislodgement occurred in one case (4.8%). Nineteen of the 21 devices (90.4%) lasted for the total intended duration of use.ConclusionUsing a PICC device as a TCVC in small children appears to be a safe technique, with an acceptable complication profile.

show abstract

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

Cited by 15 publications

References 25 publications

Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital

Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

Adult ‘PICC’ Device May be Used as a Tunnelled Central Venous Catheter in Children

Contact Info

Product

Resources

About