Risk factors for peripherally inserted central catheter complications in neonates

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Vascular Access

Background:

• Peripherally inserted central catheters (PICCs) are crucial for prolonged intravenous access in hospitalized infants.
• Understanding factors influencing PICC complications and nonelective removal is essential for optimizing patient care.

Purpose of the Study:

• To identify factors associated with nonelective PICC removal and complications in hospitalized infants.

Main Methods:

• Retrospective analysis of 1234 PICCs placed in 918 infants (<45 weeks postmenstrual age).
• Univariate and multivariate mixed-effects logistic regression analyses were used to assess predictors of nonelective removal and complications.

Main Results:

• Nonelective PICC removal occurred in 28.4% of infants, and complications in 34.4%.
• Upper extremity PICCs were associated with higher rates of nonelective removal and complications compared to lower extremity PICCs.
• While upper extremity PICCs showed increased malposition, they were linked to fewer cases of phlebitis, edema, and perfusion changes.

Conclusions:

• Approximately one-third of PICCs were associated with complications.
• Lower extremity PICC placement is recommended when feasible due to a potential association with fewer complications.