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Updated: Dec 31, 2025

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Risk factors for peripherally inserted central catheter complications in neonates
Gillian C Pet1, Jens C Eickhoff2, Kate E McNevin3
1Division of Neonatal-Perinatal Medicine, Washington University School of Medicine, St. Louis, MO, USA. gpet@wustl.edu.
Objective:
To determine factors associated with nonelective PICC removal and complications.
Study Design:
Overall, 1234 PICCs were placed in 918 hospitalized infants <45 weeks postmenstrual age. Outcomes studied include nonelective PICC removal (removal prior to completion of therapy) and line complications. Univariate and multivariate mixed-effects logistic regression analyses were conducted to evaluate the associations between potential predictor variables and clinical outcomes RESULTS: Nonelective PICC removal occurred in 28.4% and complications in 34.4% of infants. Nonelective removal (p < 0.001) and complications (p = 0.006) occurred more often with upper than lower extremity PICCs. Malposition in the first 72 h (p = 0.0009) and over time (p = 0.0003) were more common in upper extremity PICCS; however, upper extremity PICCs were associated with a decreased incidence of phlebitis, edema, and perfusion changes (p = 0.03).
Conclusions:
Approximately one-third of PICCs were associated with complications. When feasible, lower extremity PICCs should be placed as they may be associated with fewer complications.
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