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1198 Peripherally Inserted Central Venous Catheters in Neonate: A Quick and Efficient Standardized Technique
  1. S Breinig,
  2. S Pelluau,
  3. K Laganthe,
  4. MC Granier,
  5. M Gineste,
  6. C Alberge,
  7. MC Bloom,
  8. MO Marcoux
  1. Intensive Care Unit, Hopital des Enfants, Toulouse, France

Abstract

Background and Aims Peripherally inserted central venous catheters (PICCs) are commonly used for neonatal vascular access. Early catheter-related sepsis and catheter non infectious complications are linked with initial dressing method. We evaluate efficacy of our specific PICCs insertion protocol with trained nurses and doctors.

Methods We observed prospectively 1686 PICC procedures in neonate (0–28d) from 2002 to 2011. Silicon PICCs were inserted from 0 to 28 days corrected age. Procedure followed our specific protocol.

Results 1686 PICCs were attempted with a success rate of 96.2% in neonates with a mean gestational age of 29.7 weeks at a median age of 3 (0–94d) days of life.

In the successful PICCs, median number of venous puncture was 1 (1–13), median time spent was 20 (5–120) minutes, device change in 11.7% and site change in 5.9%. Median temperature difference between the beginning and the end of the procedure was very low: –0.2°C (–1.5 to 1.8). 187 complications (11.5%) occurred: 105 diffusions of which 6 pericardic effusions, 25 occlusions, 37 porous catheters, 7 surrounding catheter tissue inflammations. 13 PICCs were removed for infection (sepsis or local mycosis).

Conclusions Standardized protocol with specific nurse and doctor leads to a success rate of 96.2% with a small time spent for insertion and a median of one attempt mostly in the initial chosen site. This quick method leads to low neonate cooling and expose patients to minimal infection risk and complications.

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