Incidence of Nonelective Removal of Percutaneously Inserted Central Catheters According to Tip Position in Neonates

Objective To compare the incidence and reasons for nonelective removal of percutaneously inserted central catheters (PICC lines) between centrally and noncentrally placed PICC lines in neonates. Design Prospective cohort study. Setting A 60-bed, tertiary-level neonatal intensive care unit in a private hospital in SAo Paulo, Brazil. Participants Neonates who were born at the hospital and underwent successful insertion of 237 PICC lines. They were divided into two groups, central and noncentral, according to tip position. Methods Neonates were monitored daily from insertion of the PICC until its removal. Data were collected from medical records. Results Of the 237 PICCs analyzed, 207 (87.4%) had their tip in a central position and 30 (12.6%) in a noncentral position. The incidence of nonelective PICC removal was similar between the central and noncentral groups (p=.48). The reasons for nonelective removal were significantly different between the groups (p=.007), with a higher incidence of extravasation in the noncentral group. Conclusion Noncentrally placed PICCs can provide vascular access in neonates requiring venous access for the administration of intravenous solutions. Many potential catheter-related complications can be prevented by careful bedside nursing. Frequent monitoring of noncentral PICCs is necessary to detect and prevent extravasation in neonates.