Neonatal ultrasound guided PICC placement reviewed

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Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes” Johnson et al (2016).

Abstract:

BACKGROUND: Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes.

METHODS: A retrospective chart review was conducted of all patients below 1500 g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center. All patients had multiple previous attempts at PICC placement by experienced NICU vascular access nurses prior to referral. Complications were determined based on clinical and procedural notes.

RESULTS: A total of ten patients were found during the study period. The average estimated gestational age was 29.8 weeks (range 26-38 weeks).The average weight at the time of PICC insertion was 968 g (range 485-1390 g). All attempts at placement were successful. There were no complications directly related to PICC insertion.

CONCLUSION: Ultrasound guided PICC line placements using ultrasound is an effective technique, which can be applied to very low and extremely low birth weight infants, with excellent success rates and a low risk of complications.

Reference:

Johnson, K.N., Thomas, T., Grove, J. and Jarboe, M.D. (2016) Insertion of peripherally inserted central catheters in neonates less than 1.5 kg using ultrasound guidance. Pediatric Surgery International. September 2nd. [Epub ahead of print].

DOI: 10.1007/s00383-016-3959-1

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