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PERIPHERALLY INSERTED CENTRAL CATHETERS IN NEONATES: THE SINGAPORE GENERAL HOSPITAL EXPERIENCE
  1. I L Ereno1,
  2. S K Y Ho1,
  3. C L Yeo1,
  4. W B Lian1,
  5. D K L Chan1,
  6. S H T Choo1,
  7. V A Shah1
  1. 1Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore, Singapore

Abstract

Objective To describe PICC usage and its complications.

Methods Prospective data collection was done from January 2004 to February 2008 for neonates with PICC. Information included gestation, birth weight, indication, duration, insertion sites, number of attempts, catheter tip position, catheter tip culture and complications. Definitions were adapted from the Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2002. Statistics were performed using SPSS v 11.0 and p value <0.05 considered significant.

Results 269 PICC were inserted for 211 infants, a total of 4638 catheter days for 262 PICC. There were an almost equal number of males and females (137 and 132 respectively), median gestation of 29 weeks (23–39), and median birth weight of 1150 g (415–4440). 98.5% were for parenteral nutrition. Antecubital veins were the preferred sites (98.9%). In 61%, catheter tip was at the junction of the SVC and R atrium. Median catheter duration was 18 days (1–42). Overall complication rate was 30%, infection being the most common (12.2%) followed by mechanical problems (7.2%), phlebitis (6%) and infiltration (4.6%). No documented CRBSI. BSI rate was 3.4/1000 catheter days or 6/100 catheters. Isolates were coagulase-negative Staphylococcus (60%), Gram-negative organisms and Candida albicans (12.5%), and gram-positive organisms (6%). Gender, gestation, birth weight and number of attempts were not significantly associated with complications. Mean complication-free catheter survival was 29 days (95% CI 27 to 31). Mean infection-free catheter survival was 35 days (95% CI 34 to 37).

Conclusion Catheter insertion, care and maintenance needed to be reviewed to reduce complications. Diagnostic methods without catheter removal should be considered for accurate diagnosis of CRBSI.

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