Risk factors for PICC complications in neonates

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Approximately one-third of PICCs were associated with complications. When feasible, lower extremity PICCs should be placed as they may be associated with fewer complications” Pet et al (2020).

Abstract:

OBJECTIVE: To determine factors associated with nonelective PICC removal and complications.

STUDY DESIGN: Overall, 1234 PICCs were placed in 918 hospitalized infants <45 weeks postmenstrual age. Outcomes studied include nonelective PICC removal (removal prior to completion of therapy) and line complications. Univariate and multivariate mixed-effects logistic regression analyses were conducted to evaluate the associations between potential predictor variables and clinical outcomes RESULTS: Nonelective PICC removal occurred in 28.4% and complications in 34.4% of infants. Nonelective removal (p < 0.001) and complications (p = 0.006) occurred more often with upper than lower extremity PICCs. Malposition in the first 72 h (p = 0.0009) and over time (p = 0.0003) were more common in upper extremity PICCS; however, upper extremity PICCs were associated with a decreased incidence of phlebitis, edema, and perfusion changes (p = 0.03). CONCLUSIONS: Approximately one-third of PICCs were associated with complications. When feasible, lower extremity PICCs should be placed as they may be associated with fewer complications.

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Reference:

Pet, G.C., Eickhoff, J.C., McNevin, K.E., Do, J. and McAdams, R.M. (2020) Risk factors for peripherally inserted central catheter complications in neonates. Journal of Perinatology. January 7th. doi: 10.1038/s41372-019-0575-7. .

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