Peripherally inserted central catheters in the neonatal period

Abstract

PuRPOsE: Peripherally inserted central catheters (PICC) have been extensively used in neonates. However, insertion of these thinnest catheters is a very delicate procedure associated with a high failure rate. In our Neonatal Surgical Intensive Care Unit, we developed a very easy new PICC insertion and evaluated the neonates treated with PICCs which were inserted by using our technique as well as catheter features such as success rate, number of insertion attempts, reason for removal and complications. METHOds: Information was retrospectively collected on all 40 PICCs inserted at Kutahya Evliya Celebi Goverment Hospital andDicle University Hospital during a 6-years period from September 2004 to September 2010. REsuLTs:A total of 40 PICCs were inserted in 37 patients (26, 70% males, 11, 30% females) by using new technique. The median age of patients was 8.3 days (range 1 to 66 days) and the median weight of patients was 2365 g (range 600 to 5000 g). The vein most commonly accessed was long saphenous vein (85%). The length of PICCs in the body was 19.6 cm (range 5 cm to 30 cm). The tip was located in a central vein in all patients. Surgical abdomen was the most common cause for PICC insertion (38%). Duration of catheterization was 7.7±5.6 days (1-F 5.5 days, 2-F 8.6 days). Almost all of the PICCs were inserted successfully (40/42, success rate 95%) and in the first venipucture (36/42, 86%). Completion of therapy and removed after death were achieved with 87% of PICCs.Three minor complications were noted. Minor bleeding in the insertion site which was stopped via compression occurred in two neonates. Major complication was not seen. No deaths were directly attributed to PICCs use. CONCLusION: The new insertion technique of the neonatal peripherally inserted central catheters may be one of the easiest and safest techniques, in comparison to previous techniques reported in the literature.Keywords: Catheterization, Peripheral. Techniques. Infant, Newborn. REsuMOOBJETIVO: Cateteres centrais de inserção periférica (PICC) têm sido usados extensivamente em neonatos. Entretanto, a inserção destes cateteres tão finos é um procedimento muito delicado associado a uma elevada taxa de falha. Em nossa Unidade de Cuidado Intensivo Neonatal, nós desenvolvemos uma técnica muito fácil de inserção de PICC e avaliamos os neonatos tratados com PICCs que foram inseridos usando nossa técnica assim como características relacionadas ao cateter tais como taxa de sucesso, número de tentativas de inserção, razão de remoção e complicações. MéTOdOs: Informações foram coletadas retrospectivamente de todos os 40 PICCs inseridos no Kutahya Evliya Celebi GovermentHospital e Dicle University Hospital durante um período de seis anos, desde Setembro de 2004 até Setembro de 2010.REsuLTAdOs: Um total de 40 PICCs foi inserido em 37 pacientes (26 homens, 70%, 11 mulheres, 30%) usando a nova técnica. A idade media dos pacientes foi de 8,3 dias (variando entre 1 e 66 dias) e a mediana do peso dos pacientes foi 2365g (variando entre 600g e 5000g). A v...

Risk of Infection Using Peripherally Inserted Central and Umbilical Catheters in Preterm Neonates

“…11 The most commonly used alternative mode of venous access is peripherally inserted central catheters (PICCs). [12][13][14][15][16][17][18][19][20] These catheters provide prolonged central venous access, are considered cost effective, 21,22 and have a longer indwelling time before the risk of LOS increases. 23 The risk of LOS associated with PICCs has been reported to increase after an indwelling time of 35 days, 24 compared with 7 days with UVCs.…”

Fatores de risco para infecção de corrente sanguínea associada ao cateter central de inserção periférica em neonatos

“…Mechanical and infectious complications occur in 13 -50.7% of newborns using the device, such as: obstruction, phlebitis, thrombosis, rupture, extravasation, and bloodstream infection. (3,4) One of the most frequent complications is a bloodstream infection associated with the catheter, generating costs and suffering for the newborn and his family, as well as a significant increase in morbidity and mortality in infants in NICUs. The incidence of this complication is highly variable, ranging from 1.2 to 24.8%, due to the different concepts and terminologies adopted by authors.…”

A comparison of two intravenous infusion devices in lung carcinoma patients receiving combined radiotherapy and chemotherapy

“…Patients with PICCs needed to return repeatedly to the hospital for dressing changes; this reduced the recuperation time at home and increased the risk of complications, such as infection during radiotherapy. [10] Although, the catheter could prevent chemotherapy phlebitis and could ensure that patients with poor vascular conditions could continue to use and it caused problems in day-to-day living, when radiotherapy still continued. Therefore, nurse should choose an appropriate method of puncture according to patient's symptoms, whether undergoing radiotherapy, as well as vascular conditions, patient's chemotherapy history, location, patient's wishes, and the body condition.…”