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Central line retrieval in a neonate.

Vikas Kohli1, Raja Joshi

  • 1Pediatric Cardiology & Congenital Cardiac Surgical Unit, Apollo Centre for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India. vkohli_md@yahoo.com

Indian Journal of Pediatrics
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A migrated peripherally inserted central catheter (PICC) in a preterm infant was successfully retrieved from the pulmonary valve using a snare technique. This case highlights a rare complication and a novel retrieval method for neonatal intensive care.

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Area of Science:

  • Neonatal intensive care
  • Pediatric cardiology
  • Medical device management

Background:

  • Peripherally inserted central catheters (PICCs) are crucial for neonatal intensive care.
  • PICC line migration is a rare but serious complication, occurring in approximately 1% of cases.
  • Prompt identification and management of migrated lines are essential to prevent adverse outcomes.

Observation:

  • A preterm infant in intensive care developed a migrated PICC line.
  • The migrated PICC line became enmeshed on the pulmonary valve, posing a significant risk.
  • This migration was identified and required immediate intervention.

Findings:

  • A novel snare-based retrieval technique was successfully employed to remove the PICC line from the pulmonary valve.
  • The retrieval procedure was technically challenging due to the infant's small size.
  • Successful retrieval mitigated the immediate risk to the infant's cardiovascular system.

Implications:

  • This case demonstrates a viable, minimally invasive technique for managing migrated PICC lines in neonates.
  • The described technique offers a potential solution for similar rare complications in small infants.
  • Further research into PICC line placement and migration prevention in neonates is warranted.