Comparing Midline and Peripherally Inserted Central Catheters-A Randomized Feasibility Trial.

Objectives: The most effective use of midline catheters in children is not understood. We aimed to (1) test the feasibility of a trial comparing peripherally inserted central catheters (PICCs) to midline catheters in hospitalized children in need of durable vascular access and (2) collect preliminary effectiveness data of the 2 devices.

Methods: Our study combined a single site, randomized controlled feasibility trial (RCT, primary study) and a prospective observational study (alternative study) comparing PICCs to midline catheters.

Children with sickle cell disease and fever but no respiratory symptoms: Is a chest x-ray needed?

Background: The National Heart, Lung, and Blood Institute (NHLBI) defines acute chest syndrome (ACS) as a new infiltrate on chest x-ray (CXR) and at least 1 of the following: fever (≥38.5C), hypoxia, or respiratory symptoms. NHLBI expert consensus recommends a CXR in patients with sickle cell disease (SCD) who have fever and respiratory symptoms.

Use of central venous access devices outside of the pediatric intensive care units.

Background: Central venous access devices (CVAD) are associated with central line associated bloodstream infection (CLABSI) and venous thromboembolism (VTE). We identified trends in non-intensive care unit (ICU) CVAD utilization, described complication rates, and compared resources between low and high CVAD sites.

Methods: We combined data from the Pediatric Health Information System (PHIS) database and surveys from included hospitals.

Acute care utilization among individuals with sickle cell disease and related cardiopulmonary and renal complications.

Cardiopulmonary and renal end organ (CPR) complications are associated with early mortality among individuals with sickle cell disease (SCD). However, there is limited knowledge regarding acute care utilization for individuals with SCD and CPR complications. Our objective was to determine the prevalence of CPR complications in a state specific SCD population and compare acute care utilization among individuals with and without CPR complications.