Peripherally inserted central catheter in extremely preterm infants: Characteristics and influencing factors

J. van den Berg*, J. Lööf Åström, J. Olofsson, M. Fridlund, A. Farooqi | JNPM 2017;

Abstract.
OBJECTIVE
: To evaluate the duration of catheter stay, incidence of non-elective removal and rates of complications associated with peripherally inserted central catheters (PICCs) in relation to different catheter positions in extremely preterm infants (EPT, <28 weeks of gestation).
METHODS: A retrospective analysis of Peripherally Inserted Central Catheters (PICCs) inserted in EPT infants over a 10-year period, from January 2004 through December 2013 (mean gestational age, 25.2 weeks; mean birth weight, 727 g).
RESULTS: Of the 379 PICCs analyzed, the majority of lines (68%) were placed in the central position, and 259 PICCs (56%) were removed electively after fulfilment of the treatment. Significantly more PICCs in the lower extremities compared to the upper extremities were in central positions (86% vs 61%, p  < 0.001, respectively). Significantly more PICCs that were removed electively after fulfilment of the treatment were in a central position compared to a non-central position (p  < 0.001). Of the 166 catheters that were removed because of complications, most (71%) of them had mechanical problems, and 13% had sepsis resulting in an incidence rate of 4.4/1000 catheter days. CONCLUSION: PICCs inserted in the lower extremity were more likely to have a centrally placed tip position compared to PICC lines inserted in the upper extremities.

*Corresponding Author: 

Johannes van den Berg, MD, NICU, Barn 4, University Hospital, Umeå, SE-901 85 Umeå, Sweden. Tel.: +46907850300; Fax: +46907852098; E-mail: Johannes.berg@pediatri.umu.se.