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Purpose: To identify patient and device-related factors associated with PICC complications in the CICU and ACCU at Children's Health Dallas

Methods: - Single center, retrospective study using data abstracted from electronic medical records (EMR). - All PICCs inserted in HC during January 2022 through November 2024 were analyzed. - Retrospective review completed to identify patient physiology (at time of insertion), tip terminating location, tPA doses given (if applicable), and removal reason. - Univariate analysis conducted to determine risk factors associated with line occlusion and tPA usage.

Results: - Occlusion was the most frequent indication for early line failure/removal - Univariate analysis confirmed many previously assumed findings. tPA administration (Table 3): -Infant and school-age child demographic groups are clinically significant when compared to adolescent - A Bi-V infant is 1.9x more likely than a Bi-V child/adolescent - A lower extremity PICC is 1.5x more likely than an upper extremity - A PICC terminating in the IVC/ICAJ is 2xmore likely than a PICC that terminates in the RA Line removal due to occlusion (Table 4): - A Bi-V infant and SV infant are 3x more likely to occlude than a Bi-V child/adolescent - A left extremity PICC is more likely to occlude than on a right extremity - A PICC terminating in the IVC/ICAJ or in the subclavian are 2.3x and 3.6x more likely to occluded compared to the SVC/SCAJ terminating location Continued research within the HC at Children’s Health Dallas as well as collaboration among HCs should occur to develop predictive model.

Publication Date

11-24-2025

Disciplines

Pediatric Nursing

Peripherally Inserted Central Catheter Use and Complications in a Pediatric Heart Center

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