Atypical use of PICC as centrally inserted central catheter in infants and neonates: Report of a 10-year experience

Nourzaie, Romman; Abbas, Hiba; Parthipun, Aneeta; Boolkah, Soo; Ahmed, Irfan; Gkoutzios, Panos; Moser, Steven; Monzon, Leonard; Karunanithy, Narayan; Διαμαντόπουλος, Αθανάσιος

doi:10.1177/11297298211034308

Cited by 5 publications

(11 citation statements)

References 28 publications

(76 reference statements)

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“…(72 tncCVCs) and Lawson and Zealley 8 (6 tncCVCs) reported zero incidence of device dislodgement. Nourzaie et al 11 . (182 tncCVCs) described a dislodgement rate of almost 11% ( n = 20), and Lindquester et al 10 .…”

Section: Resultsmentioning

confidence: 98%

“…(27 tncCVCs) reported three cases of early removal representing 11% of all patients. Nourzaie et al 11 . (182 tncCVCs) reported 40 cases representing 22% of all patients, and Ullman et al 18 .…”

Section: Resultsmentioning

confidence: 99%

“…All studies with one exception reported CLABSIs as an outcome (572 tncCVCs; unclear catheter days). Nourzaie et al 11 . reported 11 infections in 182 devices (6%), whilst Short 19 reported 5 infections in 39 tunnelled devices (12.8%).…”

Section: Resultsmentioning

confidence: 99%

“…Most commonly inserted in the internal jugular vein, tncCVCs may also be inserted in the femoral vein. For jugular vein tncCVCs, the device is ‘tunnelled’ subcutaneously from an exit site on the anterior chest wall to a supraclavicular neck incision to optimise jugular vein puncture 8–12 . The device only enters the vein at this point.…”

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confidence: 99%

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Performance of tunnelled, non‐cuffed central venous catheters in infants: A scoping review

Dean,

Doyle,

Ullman

2023

J Paediatrics Child Health

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AimTo summarise and critique existing knowledge and evidence relating to the utility, and post‐insertion complications surrounding tunnelled non‐cuffed central venous catheters (tncCVCs) in infants.MethodsA scoping review of original research studies reporting the use of, and post‐insertion complications associated with, tncCVCs in infants was completed. MeSH terms were used to formulate a systematic search, and data were extracted using a customised data extraction form. Data were analysed descriptively across key themes based on the research questions. Study quality was evaluated using the Mixed Methods Appraisal Tool.ResultsThe systematic search generated 3994 studies, of which 9 studies met final inclusion criteria. Studies included 644 tncCVCs in infants based in the USA, Europe and Australia. Most studies were retrospective cohort studies. The most common vein of insertion, where individually specified, was the internal jugular (n = 177). Tunnel length, where reported, was 2.5–5 cm. Infection rates were most commonly reported (eight studies), with results ranging from 0 to 12.8%, and device dislodgements of up to 20% reported. Participant follow‐up and definition of complications varied greatly between studies. Study quality across all papers was sound.ConclusionsThis review has identified only a small number of studies, with small participant numbers, reporting the performance of tncCVCs in infants. Definitions of complications measured varied significantly between studies, and vastly different patient follow‐up protocols were reported. Further larger‐scale studies on the performance of tncCVC, employing internationally recognised reporting standards is warranted to ensure clinicians can make informed choices for medication and infusion delivery.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Performance of tunnelled, non‐cuffed central venous catheters in infants: A scoping review

Dean,

Doyle,

Ullman

2023

J Paediatrics Child Health

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“…Peripherally inserted central catheters (PICC) are commonly used in neonatal intensive care units (NICUs) to treat critically ill neonates, especially premature infants. However, PICC can cause complications such as catheter-related blood stream infection (CRBSI), chylothorax, chyloma, arrhythmia, catheter displacement, phlebitis, and venous thrombosis [ 1 , 2 , 3 , 4 ]. PICC-related venous thrombosis is one of the more serious complications.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants

2022

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Background: This study aimed to analyze clinical characteristics and risk factors for peripherally inserted central catheter (PICC) placement in premature infants. Materials: This study included seven premature infants who were hospitalized in the neonatal intensive care unit (NICU) of Peking University Third Hospital from 1 January 2014–30 June 2021, and suffered PICC-related venous thrombosis. The control group included premature infants (n = 56) matched (1:8) by the following: Did not experience venous thrombosis; born with a similar gestational age (±2 w), birth weight (±200 g); and received PICC catheterization in the same period (±4 w). Clinical neonatal data were collected through the hospital electronic medical record system and analyzed using SPSS version 23. Results: The incidence of PICC-related thrombus was 0.23% (7/3043. Univariate analysis revealed that, compared to the non-thrombotic group, mothers in the thrombosis group had autoimmune diseases (χ2 = 9.844, p = 0.030) and used anticoagulative drugs during pregnancy (χ2 = 8.036, p = 0.025). The corrected gestational age when PICC-related thrombosis occurred in the thrombosis group was 32 + 6 (30 + 1, 34 + 1) weeks. The average time from catheter placement to thrombosis was 5 (1, 12) days. Among infants, 85.7% (6/7) experienced deep vein thrombosis, of which four were in the lower extremity veins; three occurred within 2 days after central venous catheter extubation, and four occurred during central venous catheter indwelling. The clinical manifestations of thrombosis include skin edema, color changes, and skin temperature changes in the affected limbs. The seven neonates had normal coagulation at the time of thrombus diagnosis, but D-dimers significantly increased 1–2 days after thrombosis, returning to normal 5–8 days after thrombus. The thrombus persisted for 4.5 (3, 8) days. All seven neonates were treated with low molecular weight heparin calcium anticoagulation for 10 (3, 17) days and recovered completely. Conclusions: PICC-related thrombosis occurred within 1 week after catheter placement, and thrombosis more likely happened in infants whose mothers had autoimmune disease. When this high-risk factor exists and the patient has been intubated for 1 week and has sudden swelling in the intubated limb, venous ultrasound should be performed immediately to diagnose, and treatment should be provided in a timely manner to reduce adverse events.

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Tunneling Central Venous Catheters to the Scapular Region in Pediatric Patients with Attention Deficit Disorder and Autism

Ostroff

Connolly

2022

Ultrasound Guided Vascular Access

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Atypical use of PICC as centrally inserted central catheter in infants and neonates: Report of a 10-year experience

Cited by 5 publications

References 28 publications

Performance of tunnelled, non‐cuffed central venous catheters in infants: A scoping review

Performance of tunnelled, non‐cuffed central venous catheters in infants: A scoping review

Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants

Tunneling Central Venous Catheters to the Scapular Region in Pediatric Patients with Attention Deficit Disorder and Autism

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