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
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.
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
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).
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.