Complications of peripherally inserted central venous catheters in neonates: Lesson learned over 2 years in a tertiary care centre in India

Singh, Amit; Bajpai, Minu; Panda, Shasanka Shekhar; Jana, Manisha

doi:10.4103/0189-6725.137334

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…Other common complications of PICC placement include blockage, leakage, thrombosis, and pneumothorax [10] . However, pneumothorax rarely occurs in infants with the PICC line [15] . Pneumothorax refers to the presence of air in the pleural cavity that may occur spontaneously or as a result of trauma [16] .…”

Section: Discussionmentioning

confidence: 99%

“…Positive pleural pressure is a life-threatening condition since it causes severe ventilatory impairment so that the positive pressure is transmitted to the mediastinum, resulting in reduced venous return and decreased cardiac output [16] . Pneumothorax may occur during lung biopsy or pleural drainage due to the perforation of the visceral pleura and the leakage of air into the lungs [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of where and how they are inserted, dangerous complications have been associated with the use of central catheters. In contrast to central catheters, PICC are less invasive and also in-expensive [15] .…”

Section: Discussionmentioning

confidence: 99%

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Pneumothorax as a rare complication of peripherally inserted central catheter (PICC) in neonates: A case report study

Goli

Zafarmokhtarian

Ghalandari

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance The Peripherally Inserted Central Catheter (PICC) placement is associated with complications such as deep vein thrombosis, phlebitis, air embolism, infection, and superior vena cava syndrome. The aim of this study is to report pneumothorax as a rare complication of PICC insertion in a newborn. Case presentation The present case report is of a 32-week- and 4-day-old female fetus who was born at Mahzad Obstetrics and Gynecology Hospital, Urmia, Iran. A PICC was placed for the infant. The infant underwent an antero–posterior chest X-ray, in which the presence of a complete white-out of the right hemithorax indicated pneumothorax and right lung collapse. The review of literature in this field showed that there were no reports of pneumothorax as a complication of PICC insertion in neonates. Clinical discussion Despite that the PICC placement seems to have many medical advantages in infants, it may cause life-threatening complications such as pneumothorax. In this newborn, the PICC placement was the main cause of pneumothorax and it can be stated that the catheter tip might cause trauma to the chest wall during the placement procedure which resulted in an air trap in the pleural cavity and eventually right lung collapse. Conclusion There are a couple of rare cases being reported to have complications of PICC placement in neonates, but none had associated pneumothorax and PICC placement in neonates. Therefore, innovative methods require to be used for meeting the nutrition and fluid requirements of the infants for a long time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pneumothorax as a rare complication of peripherally inserted central catheter (PICC) in neonates: A case report study

Goli

Zafarmokhtarian

Ghalandari

et al. 2021

International Journal of Surgery Case Reports

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“…Such complications can cause an increase in the costs of health services due to the increase in the length of stay in the NICU, as well as injuries to NBs, such as tissue, cardiological, and infectious injuries. Previous studies on complications related to the use of PICC in NBs have demonstrated the prevalence of tissue complications (edema, phlebitis, enlargement, and necrosis) and systemic complications (arrhythmias, cardiac tamponade, and sepsis) [3,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of complications associated with the use of a peripherally inserted central catheter in newborns: A systematic review protocol

et al. 2021

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Background The improper handling of a peripherally inserted central catheter (PICC) in newborns (NBs) may result in mechanical and infectious complications. Aim The aim of this systematic review (SR) is to estimate the prevalence of complications associated with the use of PICC in NBs. Methods We will utilize PubMed, Embase, CENTRAL, Web of Science, Scopus, Cochrane Library, CINAHL, and Google Scholar for the databases search. There will be no restrictions on the search for languages, and observational studies will be selected wherein the prevalence rate of complications associated with the use of PICC in NBs has been presented or can be calculated. The systematic review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two reviewers will independently select studies and assess their eligibility using predefined criteria. Using standardized forms, two other reviewers will independently extract data from each included study, and the random-effects pooled prevalence will be calculated in the meta-analysis with the respective 95% confidence intervals. The methodological quality of the studies will be assessed using the modified Newcastle-Ottawa Scale. Review Manager V.5.3.5 will be used for the qualitative and quantitative synthesis. A protocol was developed and published on PROSPERO (Registration number CRD42020211983). Expected results This SR will show the prevalence of complications caused by the inadequate management of PICC in NBs, which is information considered important for clinical practice improvement.

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“…It is claimed that the use of a PICC may result in embolization, cardiac tamponade, or pleural effusion. Although rare, these complications are potentially life-threatening [15,18]. According to the data of various studies, 41–50% of PVCs are removed or changed as a result of complications, the most common being local infiltration, extravasation, or occlusion [11,19].…”

Section: Introductionmentioning

confidence: 99%

Influence of Parenteral Nutrition Delivery Techniques on Growth and Neurodevelopment of Very Low Birth Weight Newborns: A Randomized Trial

et al. 2019

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Background and Objectives: In very low birth weight (VLBW) newborns, parenteral nutrition (PN) is delivered via a peripheral venous catheter (PVC), a central venous catheter (CVC), or a peripherally inserted central venous catheter (PICC). Up to 45% of PICCs are accompanied by complications, the most common being sepsis. A PVC is an unstable PN delivery technique requiring frequent change. The growth and neurodevelopment of VLBW newborns may be disturbed because of catheters used for early PN delivery and complications thereof. The aim of the conducted study was to evaluate the effect of two PN delivery techniques (PICC and PVC) on anthropometric parameters and neurodevelopment of VLBW newborns. Materials and Methods: A prospective randomized clinical trial was conducted in VLBW (≥750–<1500 g) newborns that met the inclusion criteria and were randomized into two groups: PICC and PVC. We assessed short-term outcomes (i.e., anthropometric parameters from birth until corrected age (CA) 36 weeks) and long-term outcomes (i.e., anthropometric parameters from CA 3 months to 12 months as well as neurodevelopment at CA 12 months according to the Bayley II scale). Results: In total, 108 newborns (57 in the PICC group and 51 in the PVC group) were randomized. Short-term outcomes were assessed in 47 and 38 subjects, and long-term outcomes and neurodevelopment were assessed in 38 and 33 subjects of PICC and PVC groups, respectively. There were no differences observed in anthropometric parameters between the subjects of the two groups in the short- and long-term. Mental development index (MDI) < 85 was observed in 26.3% and 21.2% (p = 0.781), and psychomotor development index (PDI) < 85 was observed in 39.5% and 54.5% (p = 0.239) of PICC and PVC subjects, respectively. Conclusions: In the short- and long-term, no differences were observed in the anthropometric parameters of newborns in both groups. At CA 12 months, there was no difference in neurodevelopment in both groups.

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Complications of peripherally inserted central venous catheters in neonates: Lesson learned over 2 years in a tertiary care centre in India

Abstract: Precautions should be taken and position must be confirmed during and after PICC insertion to avoid undue complications.

Cited by 14 publications

References 28 publications

Pneumothorax as a rare complication of peripherally inserted central catheter (PICC) in neonates: A case report study

Pneumothorax as a rare complication of peripherally inserted central catheter (PICC) in neonates: A case report study

Prevalence of complications associated with the use of a peripherally inserted central catheter in newborns: A systematic review protocol

Influence of Parenteral Nutrition Delivery Techniques on Growth and Neurodevelopment of Very Low Birth Weight Newborns: A Randomized Trial

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