Technique for replacement of Groshong (R) peripherally inserted central venous catheters (PICCs) in children

BACKGROUND: The use of peripherally inserted central catheters (PICCs) in children is increasingly common due to their certain advantages and low rate of adverse events. Valved PICCs, when displaced, must be removed and new a PICC must be placed in another vein. We present our PICC replacement technique over a Seldinger guidewire using the same entrance vein. METHODS: This prospective study involved all consecutive patients with a previously inserted Groshong PICC (Bard Access Systems Inc., Salt Lake City, UT, USA) requiring replacement due to displacement managed at our institution between January 2018 and January 2019. All procedures were performed at the patients bedside, under local anesthesia. All the steps of the procedure were described. RESULTS: The procedure was performed in 19 patients (mean 10.4 years, range 5-18 years) in a mean time of 12 minutes (range 10-35). In all cases, the maneuver was quick and painless. No complications were encountered during the procedure and at follow-up. CONCLUSIONS: Our preliminary experience suggests that the PICC replacement technique using the same entrance vein is simple, safe, and feasible, and provides clear benefits to preserve childrens venous patrimony.