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Arterial embolism caused by a PICC in a premature infant – Full Text

"The case of an extremely premature infant (born at gestational age 28+3) in whom the left upper extremity artery was accidentally entered during peripheral puncture of the central venous catheter is reported" Huang et al (2020).
Abstract:

Background: Extremely premature infants have poor vascular conditions. Operators often choose deep veins such as the femoral vein and axillary vein to peripherally insert central catheters, and these vessels are often accompanied by arteries; thus, it is easy to mistakenly enter the artery.

Case summary: The case of an extremely premature infant (born at gestational age 28+3) in whom the left upper extremity artery was accidentally entered during peripheral puncture of the central venous catheter is reported. On the 19th day of hospitalization, the index finger, middle finger and ring finger of the left hand were rosy, the left radial artery and brachial artery pulse were palpable, the recovery was 95%, and the improvement was obvious. At discharge 42 d after admission, there was no abnormality in fingertip activity during the follow-up period.

Conclusion: Arterial embolization in preterm infants requires an individualized treatment strategy combined with local anticoagulation and 2% nitroglycerin ointment for local tissue damage caused by arterial embolism in the upper limb. Continuous visualization of disease changes using image visualization increases the likelihood of a good outcome.

Reference:

Huang YF, Hu YL, Wan XL, Cheng H, Wu YH, Yang XY, Shi J. Arterial embolism caused by a peripherally inserted central catheter in a very premature infant: A case report and literature review. World J Clin Cases. 2020 Sep 26;8(18):4259-4265. doi: 10.12998/wjcc.v8.i18.4259. PMID: 33024787; PMCID: PMC7520772.