Pseudo-tunneling procedure: an advantageous and safe technique for brachial catheters in younger children

Background: The aim of this study is to present our experience with the use of a particular tunneling technique called pseudo-tunnelling, during insertion of peripherally inserted central catheters (PICCs) and Midlines in younger patients. The children's brachial veins at the middle third of the arm are usually too small for cannulation. So the veins in the axilla are the best option for implantation of a four or five French catheter. A pseudo-tunneling procedure can create an exit site at the middle of the arm without using other procedural sets. Methods: From January 2014 to August 2022, 60 PICCs and 113 midlines were inserted in children admitted to Children Hospital of Brescia. Results: Every procedure was successfully performed during the first or the second time at latest. The time of procedure was not significantly different from non tunnelized procedures. No insertion related complications were observed. Conclusions: Our data suggests that pseudo-tunneling is a safe and effective procedure for brachial device implants to avoid central venous catheterization even in pediatric patients.