Retained Peripherally Inserted Central Venous Catheter in a Neonate: Consider Thrombosis

We report two neonates with stuck Premicath (R) being freed with topical and systemic thrombolytic respectively. One term baby with Premicath (R) inserted for hyperosmolar dextrose solution infusion. On removal after 13 days' use, difficulty was noted in pulling out the distal 3.5 cm part. Three thousand units of urokinase in 0.3 ml normal saline was instilled and aspirated after 14 hours, together with the intact Premicath (R) removed. Another extreme preterm baby had Premicath (R) inserted for paternal nutrition infusion. Removal of Premicath (R) was decided on day 23 of catheter use. However, great resistance was noted after pulling out 4 cm to 10 cm marking at entry site. Ultrasound study suggested thrombosis inside the lower end of IVC, with extension to the upper left common iliac vein. Six weeks course of subcutaneous enoxaparin was started and the intact Premicath (R) was successfully removed on day 12 of enoxaparin treatment.