Arterial embolism caused by a peripherally inserted central catheter in a very premature infant: A case report and literature review

Abstract

BACKGROUND Extremely premature infants have poor vascular conditions. Operators often choose deep veins such as the femoral vein and axillary vein to peripherally insert central catheters, and these vessels are often accompanied by arteries; thus, it is easy to mistakenly enter the artery. CASE SUMMARY The case of an extremely premature infant (born at gestational age 28 +3 ) in whom the left upper extremity artery was accidentally entered during peripheral puncture of the central venous catheter is reported. On the 19 th day of hospitalization, the index finger, middle finger and ring finger of the left hand were rosy, the left radial artery and brachial artery pulse were palpable, the recovery was 95%, and the improvement was obvious. At discharge 42 d after admission, there was no abnormality in fingertip activity during the follow-up period. CONCLUSION Arterial embolization in preterm infants requires an individualized treatment strategy combined with local anticoagulation and 2% nitroglycerin ointment for local tissue damage caused by arterial embolism in the upper limb. Continuous visualization of disease changes using image visualization increases the likelihood of a good outcome.

Inadvertent Arterial Placement of a Peripherally Inserted Central Catheter in an Infant With Dilated Cardiomyopathy: A Case Report

“…Arteries are reported to be compressible in patients with a systolic arterial pressure below 60 mmHg [ 3 ]. Although rare, inadvertent arterial PICC placement has been reported predominantly in small infants and neonates [ 4 - 5 ]. This may be due to the low blood pressure and the small diameters of the arteries, where luminal flow can be easily compromised by tourniquet application.…”