Outcome of Neonatal Peripherally Inserted Central Venous Catheterization in Neonatal Intensive Care Unit
Rynnara Porncharoennsub, MD1, Pichada Saengrat, MD1
Affiliation : 1Department of Pediatric, Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand
Background: Peripherally inserted central venous catheters (PICCs) are essential in caring for sick or premature newborns. They are often used for neonatal vascular access and provide life-sustaining parenteral nutrition and medication.
Objective: To determine PICC complication rates and risk factors for PICCs complications in the neonatal intensive care unit (NICU).
Materials and Methods: This was a retrospective study of 182 critically-ill neonates who received PICCs in the NICU between 2018 and 2023. The outcomes studied included non-elective PICC removal, occlusion, leakage, and catheter-related sepsis.
Results: The mean gestational age (GA) of neonates in whom PICCs were placed was 29.2±3.44 weeks, and the mean birth weight (BW) was 1,155.8±189 grams. The average length of stay was 17.5±5.2 days. The total number of complications was 33%; common complications were occlusion (13.7%), leakage (11.5%), non-elective PICC removal (6%), and central line-associated bloodstream infection (CLABSI) (2.7%). Factors associated with complications were upper extremity catheterization and length of stay greater than 14 days.
Conclusion: Complications occurred in about one-third of PICCs. Incidence rate of complications was 15.3 per 1,000 catheter days. The results informed the development of guidelines and management of PICCs in the neonatal intensive care unit, particularly in neonates requiring PICCs for more than 14 days and in PICC upper extremities PICC insertion.
Received 10 April 2024 | Revised 4 June 2024 | Accepted 16 July 2024
Keywords : Peripherally inserted central venous catheters; Newborn; Complication; Risk factor
