Research Mentor Name
Elika Ridelman
Research Mentor Email Address
eridelma@dmc.org
Institution / Department
Children's Hospital of Michigan Burn Center
Document Type
Research Abstract
Research Type
clinicalresearch
Graduate Level Research
no
Abstract
Title: Twice as Long, Half the Risk: PICCs Outperform CVCs in Burn Patient
Christian Hudson-Bradford MD, Megan Zacarias BS, Elika Ridelman PhD, Samantha Carranza BS, Christina Shanti MD
Background: Venous access is critical in burn care for fluid resuscitation, medication delivery, and nutritional support. While central venous catheters (CVCs) are traditionally used, peripherally inserted central catheters (PICCs) offer an alternative option with a potentially favorable safety profile, longer dwell time, and reduced need for re-insertion. This study compares patient characteristics, complication rates, and catheter duration between PICC and CVC lines in pediatric burn patients, advocating for early PICC placement when feasible.
Methods: We performed a retrospective review of 140 pediatric burn patients with central venous access from 2015-2024, categorizing them into PICC and CVC cohorts. Variables collected included demographics, burn characteristics (Total Body Surface Area (TBSA) for 2nd/3rd-degree burns), hospital length of stay (LOS), ICU days, catheter dwell time (days from insertion to removal), and line-related complications (expressed per 1000 line-days). Catheter duration was compared with Welch’s t-test and Mann-Whitney U test; effect size was reported as Cohen’s d. Duration data was available for 106 PICCs and 120 CVCs; complication counts were derived from 107 PICCs and 121 CVCs.
Results: The cohort contributed 2,095.6 PICC line-days and 1,160.4 CVC line-days. Complication rates per 1,000 line-days were generally lower for PICCs than CVCs: total complications (8.6 vs 23), CLABSI (5.25 vs 16.37), thrombosis (0.95 vs 1.72), and dislodgement (0.95 vs 0.86). Malfunction and pneumothorax occurred only in CVCs (1.72 each), while site infections were slightly higher in PICCs (1.43 vs 0.86). PICC dwell time was much longer than CVCs: mean 19.8 ± 19.2 vs 9.2 ± 6.6 days (median 14.5 vs 8; IQR 7.25–25 vs 5.5–12; range 0–99 vs 0–42). The difference was significant (Welch t = –5.38, p = 3.5 × 10⁻⁷; Mann-Whitney U = 3,872, p = 5.8 × 10⁻⁷; Cohen’s d = 0.73). Patients requiring CVCs had higher mean TBSA (32.6 % vs 25.5 %), lower mean BMI (16.2 vs 19.7 kg/m²), and were more often intubated/ventilated (69.2 % vs 55.1 %).
Conclusion: PICC lines demonstrated a markedly longer dwell time (≈ 20 days vs 9 days) and a more favorable complication profile, with significantly lower rates of total complications and CLABSI. Although PICCs showed slightly higher dislodgement and site-infection rates, the reduction in severe complications and the need for fewer re-insertions outweigh these minor drawbacks. Higher TBSA and ventilator use in the CVC cohort underscore that sicker patients may still require initial CVC placement, yet transitioning to a PICC once large-bore access is no longer critical offers both safety and efficiency advantages.
Disciplines
Medicine and Health Sciences
Recommended Citation
Hudson-Bradford, Christian MD; Zacarias, Megan BS; Carranza, Samantha BS; Ridelman, Elika PhD; and Shanti, Christina MD, "Twice as Long, Half the Risk: PICCs Outperform CVCs in Pediatric Burn Patients" (2026). Medical Student Research Symposium. 491.
https://digitalcommons.wayne.edu/som_srs/491