Pet et al reported risk factors for complications associated with a peripheral central catheter (PICC) inserted into a neonate. These can help to identify potential issues before development of a complication. The authors are from Washington University (St. Louis), University of Wisconsin, and the University of Washington Seattle.
Patient selection: neonate with peripherally inserted central catheter (PICC).
A peripherally placed catheter is the best option for central venous access in many sick infants more than 7-14 days old.
Criteria for complication: significant enough to remove line earlier than intended
Frequency of complications: 34%
Complications included:
(1) thrombosis
(2) malposition within first 72 hours
(3) dislodgment
(4) crack, break or fracture
(5) extravasation
(6) phlebitis and/or spreading erythema
(7) occlusion
(8) infection
Risk factors for complications on multivariate analysis:
(1) significant underlying abdominal defects (gastroschisis, etc.)
(2) significant cardiac diagnosis
(3) gestational age at birth < 37 weeks
(4) upper extremity lines
(5) surgery
(6) parenteral nutrition
The size of the catheter was not significant on multivariate analysis, but a catheter too large or too small could lead to a complication.
