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Abstract O-52: HOW DOES YOUR PICCOMPARE? A PILOT RANDOMIZED CONTROLLED TRIAL COMPARING INNOVATIVE PICC MATERIALS AND DESIGN IN 150 PAEDIATRIC PATIENTS

Kleidon, T.1; Ullman, A.2; Mihala, G.3; Zhang, L.2; Chaseling, B.1; Schoutrop, J.1; Rickard, C.2

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 23
doi: 10.1097/01.pcc.0000537394.76192.00
Oral Abstracts
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1Lady Cilento Children’s Hospital, Anaesthetics, Brisbane, Australia

2Griffith University, School of Nursing and Midwifery, Brisbane, Australia

3Griffith University, Centre for Applied Health Economics, Brisbane, Australia

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Aims & Objectives:

Peripherally inserted central catheters (PICCs) provide necessary vascular access for complex patients, especially those in intensive care. PICC use during critical illness can result in significant complications; including infections and thromboses. Innovative PICC material and design may prevent these complications, however independent testing is necessary to confirm its effectiveness

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Methods

A pilot RCT comparing the effectiveness of a novel anti-thrombogenic (BioFlo™) PICC in 150 paediatric inpatients admitted to Lady Cilento Children’s Hospital, Brisbane, Australia.

Intervention arms:

1. Standard Care PICC with clamp: 3fr, 4fr Polyurethane PICC (Cook);

2. Anti-thrombogenic PICC with valve: 3fr, 4fr (BioFloTM; Angiodynamics)

Primary outcomes were trial feasibility including PICC failure (thrombosis, occlusion, infection, breakage, dislodgement). Secondary outcomes were PICC complications during use

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Results

Protocol feasibility was established including; staff and patient acceptability, timely recruitment, no missing primary outcome data and attrition. PICC failure was: 22% (16/74, Standard care) and 11% (8/72, BioFlo®), corresponding to 12.6 and 7.3 failures/1000 hours (Risk ratio 0.58; 95% CI 0.21–1.43; p=0.172). PICC complications were primarily thrombosis (Standard care 7% vs BioFlo® 3%) and complete occlusion (Standard care 7% vs BioFlo® 1%). No bloodstream infections occurred. Significantly fewer BioFlo® patients had PICC complications during use (15% vs 34%; p=0.009).

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Conclusions

BioFlo® PICCs appear safer for paediatrics than traditional PICCs. Further research is required to definitively identify clinical, cost-effective methods to prevent PICC complication and failure and improve reliability of PICCs in specialised clinical areas such as intensive care and the wider inpatient and outpatient setting.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies