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Dwell times and risk of non-elective removal of 1-French peripherally inserted central catheters according to catheter tip position in very preterm infants

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Abstract

We investigated dwell times and risk of non-elective removal of 975 single-lumen 1-French peripherally inserted central catheters (1FR-PICC) according to tip position in a cohort of very preterm infants with a mean (SD) gestational age of 27+6 (2+1) weeks and a mean (SD) birth weight of 988 (294) g over an eight-year period. Infants with a 1FR-PICC inserted for continuous infusion of intravenous fluids within the first 30 days of life were eligible. Dwell times of PICC with elective versus non-elective removal, risk of non-elective removal of PICC according to tip position, and differences between upper versus lower limb catheter insertion were analysed. 33.8% PICC were removed non-electively. Median (IQR) dwell time was 193 (142–287) versus 154 (102–260) h for elective versus non-elective removal (p < 0.001). Non-elective removal was more common for lower limb insertion sites: 41 versus 31% (p = 0.002). PICC were significantly more likely to be removed non-electively when located in the axillary (odds ratio (OR) 2.08), cephalic (OR 8.93), external iliac (OR 4.99), and femoral (OR 10.31) vein.

Conclusion: In this cohort, dwell times of 1FR-PICC lines removed non-electively were similar to 1.9- or 2.0FR-PICC. PICC tips positioned in the axillary, cephalic, external iliac, and femoral veins had a higher risk of non-elective removal.

What is Known:

•Peripherally inserted central catheters (PICC) are widely used in neonatal intensive care.

•Previous studies focused on 2-French PICC and newborns of all gestational ages.

What is New:

•Dwell times of 1-French PICC removed non-electively were similar to 2-French PICC.

•1-French PICC tips positioned more peripherally had a higher risk of non-elective removal.

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Abbreviations

FR:

French

IQR:

Interquartile range

IVC:

Inferior vena cava

NICU:

Neonatal intensive care unit

PICC:

Peripherally inserted central catheter

SD:

Standard deviation

SVC:

Superior vena cava

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Authors and Affiliations

  1. Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia

    Daniela M Erhard, Sarah Nguyen, Katelyn J Guy, Dan M Casalaz & Kai König

Authors
  1. Daniela M Erhard
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  2. Sarah Nguyen
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  3. Katelyn J Guy
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  4. Dan M Casalaz
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  5. Kai König
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Corresponding author

Correspondence to Kai König.

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Funding

No funding was received for this study.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the institutional Human Research Ethics Committee (Mercy Health Inc., Melbourne, Victoria, Australia). The need for written consent was waived by the Committee as the study was considered a low-risk, quality assurance project, and all data were reviewed de-identified.

Additional information

Communicated by Patrick Van Reempts

Revisions received: 05 December 2016; 03 January 2017

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Erhard, D.M., Nguyen, S., Guy, K.J. et al. Dwell times and risk of non-elective removal of 1-French peripherally inserted central catheters according to catheter tip position in very preterm infants. Eur J Pediatr 176, 407–411 (2017). https://doi.org/10.1007/s00431-017-2854-7

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  • DOI: https://doi.org/10.1007/s00431-017-2854-7

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