Background A peripherally inserted central catheter (PICC) with its tip preferably in the vena cava is essential in caring for patients with chronic conditions in general pediatrics. However, PICC-related complications are concerning and warrant further investigations. Objectives To share the experience of a nurse-inserted peripherally inserted central catheters (PICC) program initiated in a general pediatric department. Methods A retrospective descriptive cohort study based on a prospectively collected database was conducted. All PICCs inserted in the departments of gastroenterology and pulmonology in a tertiary pediatric center from Dec. 2015 to Dec. 2019 were included in the study. Complications and risk factors were analyzed by comparing cases with and without complications. We also reported arm movements in correcting mal-positioned newly-inserted PICCs. Results There were 169 cases with a median (IQR) age of 42(6, 108) months who received PICC insertion during a 4-year period. Inflammatory bowel disease was the leading diagnosis accounting for 25.4% (43/169) of all cases. The overall complication rate was 16.4 per 1000 catheter days with malposition and occlusion as the two most common complications. Multivariate models performed by logistic regression demonstrated that young age [p = 0.004, OR (95%CI) = 0.987(0.978, 0.996)] and small PICC diameter (1.9Fr, p = 0.003, OR (95%CI) = 3.936(1.578, 9.818)] were risk factors for PICC complications. Correction of malpositioned catheters was attempted and all succeeded in 9 eligible cases by using arm movements. Conclusion The nurse-inserted PICC program in general pediatrics is feasible with a low rate of complications. PICC tip malposition and occlusion were two major PICC-related complications when low age and small catheter lumina were major risk factors. Furtherly, arm manipulation potentially is an easy and effective approach for correcting malpositioned newly-inserted PICC catheters.

Background In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China. Methods This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children’s hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method. Results Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother’s willingness to actively breast feed and building the maternal confidence in baby care. Conclusion Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother’s role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.

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Newborn infants, especially those in the neonatal intensive care unit, tend to go through a transition period in early life including complex perfusion changes. Haemodynamic monitoring allows for early detection of diseases, thus improving outcomes and can be life-saving. A reliable modality of hemodynamic monitoring requires early, direct, non-invasive and continuous detection of irreversible damage caused by insufficient tissue perfusion and oxygenation. PPI has been embedded in the latest generation of pulse oximeters, which obtain data via a sensor attached to infants' palm or sole and emit 940 nm near-infrared light. Different tissues and blood vessels absorb different amounts of light, with the amount of light absorbed by pulsatile tissues-dynamic changes of arterial blood flow, and non-pulsatile tissues-venous blood, muscle and other tissues, being detected. The amount of light absorbed by non-pulsatile tissue is constant. PPI is the percentage of the former to the latter. 1 It reflects the real-time change of peripheral blood flow and is an evaluation of pulse intensity at specific monitoring sites. 2 In the newborn population, GA has a great impact on physiology. The early postnatal PPI values of newborns at different GAs may also be different. 1 Therefore, the range and thresholds of PPI values for detecting diseases in newborns should be modified according to different GA. 1 In addition, studies which investigated PPI were previously conducted at sea level but lacked data from other altitudes. 3