JVA ISSN 1129-7298 The Journal of Vascular Access 2018, Vol. 19(2) 131–136 © The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.5301/jva.5000803 journals.sagepub.com/home/jva ORIGINAL RESEARCH ARTICLE anbiocs and for blood sampling, if necessary. In this respect, the use of peripherally inserted central catheters (PICCs) has been increasing significantly during the last few years in adult paents as they are easier to insert and safer than centrally in- serted central venous catheters (CICCs) (4-10). Furthermore, in children, conversely to CICCs, PICCs could be inserted via peripheral veins such as cephalic, basilic, or brachial veins without general anesthesia or sedaon, and with no surgical procedure. In addion, in comparison with CICCs, PICCs are also easier to remove and, overall, marginally less expensive. Pediatric literature about the use of PICCs in hematological diseases is scarce (11-14); therefore, the aim of this retrospec- ve study is to present our experience with the use of PICCs in children receiving stem-cell transplantaon, who are at a high risk of infecous and hemorrhagic complicaons. Paents and methods From January 2014 to January 2017, PICC lines were in- serted in children admied to the pediatric department of our hospital to receive bone marrow transplantaon or blood Use of peripherally inserted central venous catheters (PICCs) in children receiving autologous or allogeneic stem-cell transplantaon Stefano Benvenu 1 , Rosanna Ceresoli 2 , Giovanni Boroni 1 , Filippo Parolini 1 , Fulvio Porta 2 , Daniele Alber 3 1 Department of Pediatric Surgery, Children’s Hospital, ASST-Spedali Civili of Brescia, Brescia - Italy 2 Department of Pediatric Onco-Hematology and BMT, Children’s Hospital, ASST-Spedali Civili of Brescia, Brescia - Italy 3 Department of Clinical and Experimental Sciences, University of Brescia; Head of Pediatric Surgery, Children’s Hospital, ASST-Spedali Civili of Brescia, Brescia - Italy Introducon Condioning regimens with chemotherapy followed by autologous or allogenic blood stem-cell transplantaon are considered the standard of care for many hematological ma- lignancies, also in pediatrics (1-3). For the management of these children, an intravenous line is mandatory not only for the administraon of chemotherapy, but for total parenteral nutrion, blood and platelet transfusions, administraon of ABSTRACT Introducon: The aim of our study was to present our experience with the use of peripherally inserted central catheters (PICCs) in pediatric paents receiving autologous or allogenic blood stem-cell transplantaon. The inser- on of the device in older children does not require general anesthesia and does not require a surgical procedure. Methods: From January 2014 to January 2017, 13 PICCs were inserted as a central venous device in 11 pediatric paents submied to 14 autologous or allogeneic stem-cell transplantaon, at the Bone Marrow Transplant Unit of the Children’s Hospital of Brescia. The mean age of paents at the me of the procedure was 11.3 years (range 3-18 years). PICCs remained in place for an overall period of 4104 days. All PICCs were posioned by the same specifically trained physician and ulized by nurses of our stem-cell transplant unit. Results: No inseron-related complicaons were observed. Late complicaons were catheter ruptures and line occlusions (1.2 per 1000 PICC days). No rupture or occlusion required removal of the device. No catheter- related venous thrombosis, catheter-related bloodstream infecon (CRBSI), accidental removal or permanent lumen occlusion were observed. Indicaons for catheter removal were compleon of therapy (8 paents) and death (2 paents). Three PICCs are currently being used for blood sampling in follow-up paents aſter transplantaon. Conclusions: Our data suggest that PICCs are a safe and effecve alternave to convenonal central venous catheters even in pediatric paents with high risk of infecous and hemorrhagic complicaons such as paents receiving stem-cell transplantaon. Keywords: PICC, BMT, Children, CVC, Stem-cell, Pediatric Accepted: July 24, 2017 Published online: October 31, 2017 Corresponding author: Stefano Benvenu Department of Pediatric Surgery Children’s Hospital ASST-Spedali Civili of Brescia P.le Spedali Civili 1 25100 Brescia, Italy stefano.benvenu@asst-spedalicivili.it