Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors

C. Acun; A. Baker; L.S. Brown; K.A. Iglesia; J. Sisman

doi:10.3233/npm-200684

journal article Sep 13, 2021

Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors

C. Acun A. Baker L.S. Brown K.A. Iglesia J. Sisman

Journal of Neonatal-Perinatal Medicine Vol. 14 No. 3 pp. 411-417 · SAGE Publications

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Abstract

BACKGROUND: PICC line use is a common practice in neonatal units, but it is associated with various complications. Catheter migration is the most common complication in neonates. Periodic imaging is recommended to monitor the tip position of the PICCs, but the optimal frequency is undetermined. The incidence, timing and risk factors that are associated with PICC migration have not been fully investigated beyond 24 hrs in neonates. The aim of the study was to determine the incidence, timing and risk factors that are associated with peripherally inserted central venous catheter (PICC) migration in neonates. METHODS: This was a single center, retrospective study of 168 PICCs placed in 141 neonates in the neonatal intensive care unit (NICU) between 2015 and 2016. The incidence of catheter migration was determined radiographically at 12–24 hrs and every third day after insertion until it was removed. RESULTS: Overall incidence of PICC migration was 28%and most commonly was detected within the first three days after PICC placement (83%). The incidence of PICC migration was higher in males. The PICC migration was associated with difficulty advancing the PICC at the time of insertion and PICC dressing change. CONCLUSION: Serial evaluation of PICC placement in neonates is required to maintain proper position. Based on our experience in our unit, we recommend periodic imaging at 12–24 hrs and on the third day after PICC placement as most migration occurred within three days after insertion.

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References

33

[1]

Sharpe "Neonatal peripherally inserted central catheter practises and providers: Results from the neonatal PICC survey" Adv Neonatal Care (2017) 10.1097/anc.0000000000000376

[2]

Gupta "Migration of central venous catheters in neonates. A radiographic assessment" Am J Perinatol (2016)

[3]

Srinivasan "Migration patterns of peripherally inserted central venous catheters at 24 hours postinsertion in neonates" Am J Perinatol (2013) 10.1055/s-0033-1333672

[4]

Pet "Risk factors for peripherally inserted central catheter complications in neonates" J Perinat (2020) 10.1038/s41372-019-0575-7

[5]

Nadroo "Death as a complication of peripherally inserted central catheters in neonates" J Pediatr (2001) 10.1067/mpd.2001.111823

[6]

Trotter "Inadvertent catheterization of the ascending lumbar vein" Neonatal Netw (2009) 10.1891/0730-0832.28.3.179

[7]

Evans "Percutaneously inserted polyurethane central catheters in the NICU: One unit’s experience" Neonatal Netw (1999) 10.1891/0730-0832.18.6.37

[8]

Payne "Pneumorrhachis resulting in transient paresis after PICC line insertion into the ascending lumbar vein" Cureus (2016)

[9]

Food and Drug Administration "FDA drug bulletin: Precautions necessary with central venous catheters" Silver Spring, MD: Food and Drug Administration (1989)

[10]

Scott "Central venous catheters. An overview of Food and Drug administration activities" Surg Oncol Clin N AM (1995) 10.1016/s1055-3207(18)30433-2

[11]

Colacchio "Complications associated with central and non-central venous catheters in a neonatal intensive care unit" J Perinatol (2012) 10.1038/jp.2012.7

[12]

Jumani "Risk factors for peripherally inserted central venous catheter complications in children" JAMA Pediatr (2013) 10.1001/jamapediatrics.2013.775

[13]

Guidelines for the Prevention of Intravascular Catheter-related Infections

Naomi P. O'Grady, Mary Alexander, Lillian A. Burns et al.

Clinical Infectious Diseases 2011 10.1093/cid/cir257

[14]

Chathas "Meeting the special nutritional needs of sick infants with a percutaneous central venous catheter quality assurance program" J Perinat Neonatal Nurs (1997) 10.1097/00005237-199703000-00015

[15]

Sharpe "A national survey of neonatal peripherally inserted central catheter (PICC) practices" Adv Neonatal Care (2013) 10.1097/anc.0b013e318278b907

[16]

Connolly "Influence of arm movement on central tip location of peripherally inserted central catheters (PICCs)" Pediatr Radiol (2006) 10.1007/s00247-006-0172-8

[17]

Nadroo "Changes in upper extremity position cause migration of peripherally inserted central catheters in neonates" Pediatrics (2002) 10.1542/peds.110.1.131

[18]

Newberry "Evaluation of neonatal peripherally inserted central catheter tip movement in a consistent upper extremity position" Adv in Neonatal Care (2014) 10.1097/anc.0000000000000036

[19]

Percutaneous central venous catheterization via the great saphenous vein in neonates

YASUSHI OHKI, YASUSHI NAKO, Akihiro Morikawa et al.

Pediatrics International 1997 10.1111/j.1442-200x.1997.tb03743.x

[20]

Wen "Peripherally inserted central venous catheter-associated complications exert negative effects on body weight gain in neonatal intensive care units" Asia Pac J Clin Nutr (2017)

[21]

Wrightson "Peripherally inserted central catheter complications in neonates with upper versus lower extremity insertion sites" Adv Neonatal Care (2013) 10.1097/anc.0b013e31827e1d01

[22]

Gnannt "Variables decreasing tip movement of peripherally inserted central catheters in pediatric patients" Pediatr Radiol (2016) 10.1007/s00247-016-3648-1

[23]

Zaghloul "The superiority of point of care ultrasound in localizing central venous line tip position over time" Eur J Pediatr (2019) 10.1007/s00431-018-3269-9

[24]

Frey "PICC complications in neonates and children" J Vasc Access Dev (1999) 10.2309/108300899775703670

[25]

Sharpe "Securing PICC lines" Neonatal Netw (2009) 10.1891/0730-0832.28.2.123

[26]

Perin "Defining central venous line position in children: Tips for the tip" J Vasc Access (2015) 10.5301/jva.5000285

[27]

Jain "The use of targeted neonatal echocardiography to confirm placement of peripherally inserted central catheters in neonates" Am J Perinatol (2012) 10.1055/s-0031-1295649

[28]

McGee "Safe placement of central venous catheters: A measured approach" J Intensive Care Med (2011) 10.1177/0885066610392895

[29]

Ohki "Ultrasonographic detection of very thin percutaneous central venous catheter in neonates" Acta Paediatr (2000) 10.1111/j.1651-2227.2000.tb00769.x

[30]

Tauzin "Echocardiography allows more accurate placement of peripherally inserted central catheters in low birthweight infants" Acta Paediatr (2013) 10.1111/apa.12245

[31]

Katheria "A randomized controlled trial of ultrasound-guided peripherally inserted central catheters compared with standard radiograph in neonates" J Perinatol (2013) 10.1038/jp.2013.58

[32]

Brissaud "Sonography-guided positioning of intravenous long lines in neonates" Eur J Radiol (2010) 10.1016/j.ejrad.2009.03.017

[33]

Michel "Comparison of ultrasound and X-Ray in determining the position of umbilical venous catheters" Resuscitation (2012) 10.1016/j.resuscitation.2011.11.026

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References

Details

Published: Sep 13, 2021
Vol/Issue: 14(3)
Pages: 411-417

Authors

C

C. Acun

Pediatrics, Cleveland Clinic Children’s Hospital, Cleveland, OH, USA

A

A. Baker

THR Dallas Hospital, Dallas, TX, USA

L

L.S. Brown

Health System Research, Parkland Health and Hospital System, Dallas, TX, USA

K

K.A. Iglesia

Pediatric Radiology, Cook Children’s Hospital, Fort Worth, TX, USA

J

J. Sisman

Pediatrics, UTSW, Dallas, TX, USA

Cite This Article

C. Acun, A. Baker, L.S. Brown, et al. (2021). Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors. Journal of Neonatal-Perinatal Medicine, 14(3), 411-417. https://doi.org/10.3233/npm-200684

Peripherally inserted central cathether migration in neonates: Incidence, timing and risk factors

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