Incidence of Nonelective Removal of Single-Lumen Silicone and Dual-Lumen Polyurethane Percutaneously Inserted Central Catheters in Neonates

Abstract

Objective: To compare the incidence of nonelective removal of single-lumen silicone and dual-lumen polyurethane percutaneously inserted central catheters (PICCs). Study Design: A prospective cohort study was conducted with neonates in whom 247 PICC lines had been successfully inserted. Patients were assigned to either the single-lumen silicone group or the dual-lumen polyurethane group and nonelective removal incidence was compared using a logistic regression model. Results: Incidence of nonelective removal in dual-lumen polyurethane PICCs (n =91) was 48.3% versus 34% in single-lumen silicone PICCs (n =156). Thus, dual-lumen polyurethane catheters had a significantly increased chance of nonelective removal compared with single-lumen silicone PICCs (P =.004). The most usual complication in dual-lumen polyurethane PICCs was suspected catheter-related bloodstream infection; in single-lumen silicone PICCs it was external rupture. Conclusions: Dual-lumen polyurethane PICCs are associated with higher rates of nonelective removal and complications such as suspected catheter-related bloodstream infection. Cautious nursing care is necessary to prevent complications.

Comparing the use of silicone and polyurethane Peripherally Inserted Central Catheters in newborns: A retrospective study

“…Literature data state that the frequency of rupture of silicone PICCs ranges from 3.6-10.4% against 1-3.5% for polyurethane PICCs (Ong et al, 2010;Paiva et al, 2013;Costa et al, 2014). Corroborating with these data, in this study population, there were 16 cases of rupture (8.8%), all in silicone PICCs, and such complications occurred in the catheter insertion zone.…”

“…In a systematic review, the rates of nonelective removal were almost identical among patients using silicone PICCs and polyurethane PICCs, although the types of complications experienced differed (Seckold et al, 2014). However, diverging from findings in the literature, a cohort conducted in a neonatal unit in São Paulo, Brazil, demonstrated a higher incidence of nonelective removal in the polyurethane-type PICC group (48.3%), compared with the silicone PICC (34%, p = .004) (Costa et al, 2014). Given all the evidence presented, it is unclear which type of material is more associated with the general nonelective PICC removal, showing the need for further research to elucidate this issue.…”

“…The widespread use of PICC lines in neonatology requires evidence to strengthen the best practices, guarantee the effectiveness of infusion therapy and reduce damages to newborns, thus allowing the use of safer catheters. There are few studies exploring the influence of the type of PICC line with the incidence of successful insertion and duration, and the reasons for nonelective catheter removal in the neonatal population (Costa et al, 2014;Paiva et al, 2013;Yu et al, 2018).…”

“…Previous studies have attempted to identify predictors of PICC complications in newborns, such as lower extremity insertion (Wrightson, 2013) or femoral catheter insertion (Hsu et al, 2010), procedures that require 60 minutes or more (Tsai and Chu, 2011), duration longer than 30 days (Chu et al,2007) and non-central position of the catheter tip (Costa et al, 2013;Jain et al, 2013). However, there is little evidence on which type of PICC material causes less complications, especially in newborns (Costa et al, 2014). The lack of evidence on which type of material is more associated with successful insertion and duration, and with nonelective PICC removals, highlights the need for further research.…”

Identifying Latent Topics and Trends in Premature Infant–Related Nursing Studies Using a Latent Dirichlet Allocation Method

“…To reduce PICC-induced complications, prophylactic application of nystatin topical cream to reduce Candida species bloodstream infections 38 and the use of intravenous line filters for parenteral nutrition 39 were included. A comparison of infection rates in the use of umbilical central venous catheters versus PICCs 40 and a comparison of infection rates with single-lumen PICCs and double-lumen PICCs 41 were also performed. Necrotizing enterocolitis is a relatively common complication in premature infants, occurring in 7% to 14% of extremely premature infants 42 .…”