PICC line complication rates among preterm infants

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To examine whether there is an association between peripherally inserted central venous catheter (PICC) insertion site and complication rates among preterm infants” Bashir et al (2016).

Abstract:

Objective: To examine whether there is an association between peripherally inserted central venous catheter (PICC) insertion site and complication rates among preterm infants.

Design: We performed a retrospective analysis of the first PICCs placed in preterm infants in a tertiary neonatal intensive care unit between January 2006 and December 2010. The PICC-related complications resulting in catheter removal were compared based on site of insertion.

Results: Of the 827 PICCs, 593 (72%) were inserted in upper extremity. Lower extremity PICC group infants had higher illness severity (SNAP-II) score and more likely to be inserted later as compared with the upper extremity group. There was no significant difference in the total PICC-related complications between upper and lower extremity PICCs (31.3 vs. 26%; p > 0.05). Logistic regression analysis after adjusting for gestational age, day of line insertion, and SNAP-II score revealed that upper extremity PICCs were associated with increased risk of line infiltration (adjusted odds ratio [aOR], 2.41; 95% confidence interval [CI], 1.36-4.29) but not the total PICC complication (aOR, 1.29; 95% CI, 0.91-1.83).

Conclusion: There is no difference in total PICC-related complication between upper and lower extremity PICCs; however, the PICC-related mechanical complications vary depending on the site of insertion in preterm infants.

Reference:

Bashir, R.A., Swarnam, K., Vayalthrikkovil, S., Yee, W. and Soraisham, A.S. (2016) Association between Peripherally Inserted Central Venous Catheter Insertion Site and Complication Rates in Preterm Infants. American Journal of Perinatology. April 8th. [Epub ahead of print].

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