Abstract No. 55 Comparing Outcomes of Fluoroscopic versus Portable Placement of Peripherally Inserted Central Catheters (PICCs) and Central Venous Catheters (CVCs)

This study aims to determine if there is a difference in outcomes of fluoroscopic versus portable placement of PICCs and CVCs. We conducted a single-center, retrospective review of upper-extremity PICC placement (286 fluoroscopic cases and 60 portable cases) and femoral CVCs (56 fluoroscopic cases and 82 portable cases) in patients ages 0 to 20 years. We applied two samples t-test and Fisher's exact test as appropriate. Fluoroscopic PICC placement compared to portable PICC placement had a lower procedure time (43.9 vs. 57.9 minutes; P< .001); radiation dosage (342 vs. 590 mGy*cm2; P< .001); incidence of technical failure (0 vs. 3.3%; P=.017); incidence of catheter malfunction (1.7% vs. 12.1%; P ≤ .001) (Table 55.1). Similarly, fluoroscopic CVC placement compared to portable CVC placement had a lower procedure time (42.6 vs 54.8 minutes; P< .001); and radiation dosage (63.8 vs 405 mGy.cm2; P< .001). No technical failures were found in either CVC groups and the difference was non-significant for catheter malfunction (0 vs 7.3%; P=.08). The incidence rate of central line-associated bloodstream infection (CLABSI) was lower in fluoroscopic placements compared to portable placement (0.71 vs 2.22 case per 1000 line-day, P=.05). In summary, fluoroscopic placements had fewer complications compared to portable placement (3.2% vs 14.8%; P< .001). Fluoroscopic placement of PICC and tunneled CVCs reduces procedure time, radiation dosage, and adverse events when compared to portable placement. A detailed multidisciplinary discussion and risk assessment are essential when determining if a patient should receive central line placement at the bedside.