Dislodgement Rates of Tunneled Femoral Peripherally Inserted Central Catheters in Pediatric Oncology Patients

OBJECTIVE: The aim of the study was to compare catheter dislodgement rates between abdominal wall-tunneled femoral peripherally inserted central catheters (PICCs) and conventional upper arm PICCs in pediatric oncology patients. METHODS: A retrospective analysis included 355 pediatric oncology patients from Shandong Cancer Hospital (March 2022 to March 2025). Patients were divided into the Tunnel group (abdominal wall-tunneled femoral PICC, n = 145) and Conventional group (upper arm PICC, n = 210). The primary outcome was unplanned catheter dislodgement (external migration >3 cm or complete dislodgement). The Kaplan-Meier method estimated cumulative dislodgement rates; Cox regression identified influencing factors. RESULTS: The dislodgement rate was 12.41% in the Tunnel group vs 40.95% in the Conventional group (χ2 = 33.727, P < .001). The mean indwelling time was longer in the Tunnel group (181.50 ± 54.72 days vs 114.97 ± 55.84 days; t = -11.165, P < .001). Survival curves showed higher cumulative catheter survival in the Tunnel group (log-rank P < .001). CONCLUSION: Abdominal wall-tunneled femoral PICCs significantly reduce dislodgement risk and prolong indwelling time, providing a stable central venous access for pediatric oncology patients requiring long-term therapy.