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Risk factors for peripherally inserted central catheter complications in neonates

Journal of Perinatology volume 40, pages 581–588 (2020)Cite this article

Subjects

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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Acknowledgements

University of Washington Division of Neonatology for funding for statistical analysis; Seattle Children’s Research Institute for assistance with data collection.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Gillian C. Pet

  2. Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA

    Jens C. Eickhoff

  3. University of Washington School of Medicine, Seattle, WA, USA

    Kate E. McNevin & Julie Do

  4. Division of Neonatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Ryan M. McAdams

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Correspondence to Gillian C. Pet.

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Pet, G.C., Eickhoff, J.C., McNevin, K.E. et al. Risk factors for peripherally inserted central catheter complications in neonates. J Perinatol 40, 581–588 (2020). https://doi.org/10.1038/s41372-019-0575-7

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