Rates of complications amongst peripherally inserted central catheters in paediatric populations: a systematic review and meta-analysis

Abstract

Background Peripherally inserted central catheters have become a mainstay of treatment for a broad range of indications in both adult and paediatric populations. Despite their broad range of applications there has been an overall lack of analysis of the rates of complications associated with their use in paediatric populations. Objectives We conducted a systematic review and meta-analysis to estimate the rate of PICC associated complications in paediatric populations excluding neonates. Method We searched published literature for records discussing PICC use in paediatric populations. Statistical analysis was performed using Stata 17. We calculated pooled estimates using a 95% confidence interval using a random effects model and heterogeneity was assessed using I2. Results Of the 3689 participants there was a pooled complication rate of 6% (95% CI 5–6%; I2 = 0). Rates of infections were estimated at 3% (95% CI 3–4%; I2 = 0), thromboembolic complications at 1% (95% CI 0–1%; I2 = 0), mechanical failures were estimated at 8% (95% CI 7–9%; I2 = 0) and superficial thrombophlebitis at 1% (95% CI 0–1%; I2 = 0). Conclusion and contribution Our findings indicate that complications associated with PICC use in paediatric populations are broadly similar to those observed in the general population, with a notably lower incidence of thrombosis. We aim to add to the growing body of literature in this area and hope to improve the overall surveillance and knowledge of PICC related complications in paediatric populations.