Peripherally inserted central catheter in newborns: association of number of punctures, vein, and tip positioning

Abstract

Objective: to assess the use of peripherally inserted central catheters regarding the neonate’s profile, indications for use, and catheterized vein; the relation between the number of puncture attempts and vein; and assessment of the catheter tip position. Method: documentary, descriptive, retrospective, quantitative study, developed in a tertiary maternity hospital in Ceará. A total of 3,005 PICC insertion formularies was included and 1,583 were excluded due to incomplete data, with a convenience sampling of 1,422 insertions being obtained. Results: There were 1,200 (84.4%) newborns with gestational age below 37 weeks; 781 (54.9%) males; Apgar score above 7 in the first (628–44.2%) and fifth minutes (1,085–76.3%); and weight between 1,000 and 1,499 grams on the day of insertion (417–29.3%). Antibiotic therapy had 1,155–53.8% indications for insertion; the basilic was the most used vein (485–34.1%); basilic and cephalic veins had lower median puncture attempts and 1,124–79% insertions were centrally positioned. Conclusion: The results of this research highlight the continuous need to improve technical-scientific knowledge to qualify actions in neonatology.

Peripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates

“…The most used insertion sites were the peripheral limbs (lower and upper), this result partially corroborates with studies analyzed (20,(22)(23) , that presented the majority of PICCs inserted in the upper limbs. The choice for the upper limbs stems from the ease of positioning and puncture, reduced number of valves, larger vessels with favorable anatomy, due to the shorter path to the vena cava (20)(21)24) . However, the neonatal population presents alternative sites for central and peripheral venous catheter insertion, with risk similar associated, so it is recommended to use the best available vessel, indifferent from the extremities (5,8,25) .…”

“…complications, in particular respiratory diseases resulting from immaturity pulmonary (20)(21) , corroborating the results of this research. The most used insertion sites were the peripheral limbs (lower and upper), this result partially corroborates with studies analyzed (20,(22)(23) , that presented the majority of PICCs inserted in the upper limbs.…”

“…complications, in particular respiratory diseases resulting from immaturity pulmonary (20)(21) , corroborating the results of this research. The most used insertion sites were the peripheral limbs (lower and upper), this result partially corroborates with studies analyzed (20,(22)(23) , that presented the majority of PICCs inserted in the upper limbs. The choice for the upper limbs stems from the ease of positioning and puncture, reduced number of valves, larger vessels with favorable anatomy, due to the shorter path to the vena cava (20)(21)24) .…”

“…Regarding the catheter tip location, in this study, the majority (80.6%) presented central positioning at the time of transfusion. Inadequate location of the PICC tip can restrict or prevent its use, since there is a correlation between the position of the tip and the occurrence of infiltration, extravasation, tissue injury, formation of fibrin and venous thrombosis, with consequent obstruction (20) . It is important to highlight that, at the study site, catheters kept in a non-central position are assessed daily and are used for solutions and drugs that do not require central infusion.…”

Obstrução do cateter central de inserção periférica nas transfusões de concentrado de hemácias em neonatos

“…O motivo de internação predominante foi a prematuridade, que é considerada vulnerabili dade clínica, pela imaturidade de órgãos e sistemas, levando a uma maior susceptibilidade de complicações, em especial doenças respiratórias decorrentes da imaturidade pulmonar (20)(21) , corroborando com os resultados desta pesquisa.…”