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Published on: July 13, 2019
Peripherally inserted central venous catheters in critically ill premature neonates
Servet Ozkiraz1, Zeynel Gokmen, Deniz Anuk Ince
1Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Baskent University, Ankara - Turkey.
The Journal of Vascular Access
|July 3, 2013
Summary
Peripherally inserted central venous catheters (PICCs) are safe for critically ill premature infants, including extremely low birth weight (ELBW) neonates. While convenient for long-term treatments, potential serious complications warrant careful monitoring.
Area of Science:
- Neonatal intensive care
- Vascular access devices
- Pediatric critical care
Background:
- Peripherally inserted central venous catheters (PICCs) are increasingly used in neonatal intensive care units.
- Assessing the safety and complication rates of PICCs in premature neonates is crucial for optimizing patient care.
- Critically ill premature infants, particularly those with very low birth weight (VLBW) and extremely low birth weight (ELBW), present unique challenges for vascular access.
Purpose of the Study:
- To evaluate the safety and complication profile of peripherally inserted central venous catheters (PICCs) in critically ill premature neonates.
- To compare complication rates between VLBW and ELBW infants receiving PICCs.
- To determine the efficacy of PICCs for long-term medication and nutrition delivery in this vulnerable population.
Main Methods:
- Retrospective data collection of VLBW infants (<1500g) undergoing PICC placement over two years.
- Infants categorized into VLBW (1000-1500g) and ELBW (<1000g) groups for comparative analysis.
- Key data points included gestational age, birth weight, catheter site, duration of use, sepsis, and complication types.
Main Results:
- Successful PICC insertion was achieved in 87.3% of attempted cases (62 out of 71 infants).
- No significant difference in complication rates was observed between upper and lower extremity PICC placements.
- Median catheter dwell time was longer in the ELBW group (12 days) compared to the VLBW group (9 days), with no significant difference in reasons for removal.
Conclusions:
- PICCs are a valuable and convenient tool for administering long-term antibiotics and parenteral nutrition in both VLBW and ELBW infants.
- The complication risk associated with PICCs does not appear to be elevated in ELBW neonates compared to VLBW infants.
- Despite the ease of insertion and benefits, clinicians must remain vigilant for potential serious and fatal complications in critically ill premature neonates requiring PICC placement.
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