A Study on Peripherally Inserted Central Venous Catheter in Infants in Tertiary Care Centre

• Main Authors: Jayashree Purkayastha, M Supraja, Leslie Edward Lewis, Ramesh Bhat Y
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2017-04-01
• Series: Indian Journal of Neonatal Medicine and Research
• Subjects: complications; safety; total parenteral nutrition
• Online Access: http://www.ijnmr.net/articles/PDF/2209/25073_CE[VSU]_F(GH)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf

Introduction: The survival of an increasing number of very low birth weight and critically ill neonates heightens the need for parenteral nutrition to support growth, as well as reliable vascular access for administration of additional intravenous fluids and medications. Aim: To study the use of Peripherally Inserted Central Venous Catheter (PICC) and its complications in infants in a tertiary care centre. Materials and Methods: It is a prospective study done in a tertiary care centre. Study period was from October 2012 to August 2014. Most of the PICC lines were inserted in preterms for Total Parenteral Nutrition (TPN) administration. Single lumen polyurethane catheter (mostly 28G) was used with breakaway needle. Results: Total 124 PICC lines were inserted in 121 neonates. The median gestational age of insertion was 30 weeks (25- 40 weeks). The median birth weight was 1060g (630-3200g). The median age for insertion in our study was 3 days (1-120 days). The most common indication for insertion of PICC line in our study was in preterm neonates for administration of TPN which was 87(70.1%), most of the PICC lines were inserted in two attempts in 75 (60.5%) neonates followed by one attempt in 35 (28.2%) neonates. Most of the PICC lines were inserted by junior residents and in long saphenous vein (91.1%). The median catheter duration in our study was 11 days with a range of 1-35 days. Total of 37 complications were noted during 1467 catheter days with complication rate of 25.2 per 1000 catheter days. The most common complication noted was Catheter Associated Blood Stream Infection (CABSI) in 17 PICC lines (13.7%). PICC lines were electively removed after completion of therapy in 69(55.6%) neonates. Conclusion: PICC lines are easy to insert and safe in neonates and can be safely inserted in extreme preterm neonates also. Long saphenous vein was the best site for PICC line insertion in our study. Proper and standard PICC line care can lead to less major complications.