Atualização das recomendações da prática quanto ao cateter central de inserção periférica em recém-nascidos

Abstract

Objetivo: discorrer sobre as recomendações para prática de enfermagem mais atuais no manejo de cateter central de inserção periférica (PICC) em recém-nascidos (RNs). Conteúdo: a assistência ao RN com PICC vem sofrendo diversas alterações em relação às formas de mensuração do tamanho do cateter a ser inserido e de visualização da veia a ser puncionada, aos fatores que influenciam a escolha do sítio de inserção, ao acompanhamento da migração do cateter, à confirmação da ponta do PICC e a outros cuidados de manutenção e remoção do dispositivo. Conclusão: houve uma grande evolução do conhecimento referente ao manejo do PICC na população neonatal, mas ainda existem lacunas de conhecimento a serem exploradas. Espera-se uma melhoria da assistência ao RN que receberá um PICC.

Pericardial effusion in extremely low birthweight infants

“…However, the use of ultrasound has proven to be increasingly useful in the placement of PICC, as it allows not only their correct placement and progression to the desired location, but also the serial control of their proper position. The insertion and control of PICC position with ultrasound has several advantages, such as: improvement in success rates of PICC implantation, has shown good sensitivity in identifying the catheter tip, non‐exposure of the infant to unnecessary radiation, and the fact that is a real‐time assessment technique which provides immediate identification PICC migration and repositioning 7 …”

“…2,5 For local disease, topical corticosteroids, topical tacrolimus or intralesional corticosteroids could be considered. [6][7][8] Systemic corticosteroids can be used when there is no response to the previous treatments. In refractory cases, conventional immunosuppressors or anti-TNF alfa agents (infliximab and adalimumab) could be added.…”

“…Recently, ustekinumab, a monoclonal antibody that targets IL-23/IL-12 receptor, showed its effectiveness in MCD and could be an optional treatment. 7,9 considered safe. 2 Exceptionally, pericardial effusion can occur with cardiac tamponade in neonates, one of the most serious complications, occurring in 0.07-2% of the PICCs placed.…”

“…The insertion and control of PICC position with ultrasound has several advantages, such as: improvement in success rates of PICC implantation, has shown good sensitivity in identifying the catheter tip, non-exposure of the infant to unnecessary radiation, and the fact that is a real-time assessment technique which provides immediate identification PICC migration and repositioning. 7 However, it is necessary to have a trained operator to perform this technique.…”

Manutenção do cateter central de inserção periférica neonatal: protocolo de revisão de escopo

“…Regulation only occurred in 2001 through Resolution No. 258/2001 from the Federal Nursing Council (COFEN), wherein nursing professionals are empowered with technical and legal responsibility for PICC insertion and maintenance (11)(12)(13) . The PICC technology offers numerous advantages for neonates, allowing extended dwell times and administering highly vesicant and irritating drugs without causing tissue or vessel injury in these newborns.…”