Complications of peripherally inserted central venous catheter in <scp>J</scp>apanese neonatal intensive care units

Ohki, Yasushi; Maruyama, Kei; Harigaya, Akira; Kohno, Miyuki; Arakawa, Hirokazu

doi:10.1111/ped.12033

Cited by 59 publications

(43 citation statements)

References 22 publications

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“…The incidence of this complication for adults is unknown. Although our patient developed no problems during a one-day cannulation, it is important to recognize the possibility of PICC placement in the left paramediastinal space and its consequences even with ultrasound guidance [3,4]. This emphasizes the importance of radiography after insertion.…”

Section: Discussionmentioning

confidence: 73%

PICCing Your Way into the Pericardium: A Potential Catastrophic Complication of a PICC Line

Lee¹,

Miyakawa²,

Bergman³

et al. 2017

Vasc Med Surg

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This is a rare case of a peripherally inserted central catheter (PICC) that was found to be in the pericardiacophrenic vein on a post-procedure chest X-ray. An 82-year-old man was admitted to the medical ICU for severe sepsis with shock and a PICC was placed for vasopressor support. Malpositioning of a central venous catheter can lead to catastrophic results including, perforation, pericardial effusion and tamponade.

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Section: Discussionmentioning

confidence: 73%

PICCing Your Way into the Pericardium: A Potential Catastrophic Complication of a PICC Line

Lee¹,

Miyakawa²,

Bergman³

et al. 2017

Vasc Med Surg

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“…1,2,[10][11][12][13][14] The cumulative risk of CLABSI increases the longer a PICC remains in place, but it is unknown whether the daily risk of CLABSIs increases over the dwell time of the catheter. 15 A recent study of neonates suggested that for PICCs that remained indwelling for .35 days, the risk of CLABSIs increased by 33% per additional day the catheter was in place.…”

Section: Articlementioning

confidence: 99%

Catheter Dwell Time and CLABSIs in Neonates With PICCs: A Multicenter Cohort Study

2013

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Peripherally inserted central catheters (PICCs) are essential to deliver life-saving treatment to neonates. Longer PICC dwell times may increase the risk of central line-associated bloodstream infections (CLABSIs) in neonates, but previous studies have yielded inconsistent results, likely due to different study designs, analytic methods, and small sample sizes. WHAT THIS STUDY ADDS:The risk of CLABSIs increases during the 2 weeks after PICC insertion and remains elevated for the catheter duration. These data support daily review of PICC necessity, optimization of catheter maintenance practices, and consideration of novel strategies to prevent CLABSIs. abstract OBJECTIVE: To determine whether the daily risk of central lineassociated bloodstream infections (CLABSIs) increases over the dwell time of peripherally inserted central catheters (PICCs) in high-risk neonates.METHODS: Multicenter retrospective cohort including NICU patients with a PICC inserted between January 2005 and June 2010. We calculated incidence rates and used Poisson regression models to assess the risk of developing CLABSI as a function of PICC dwell time.RESULTS: A total of 4797 PICCs placed in 3967 neonates were included; 149 CLABSIs occurred over 89 946 catheter-days (incidence rate 1.66 per 1000 catheter-days). In unadjusted analysis, PICCs with a dwell time of 8 to 13 days, 14 to 22 days, and $23 days each had an increased risk of infection compared with PICCs in place for #7 days (P , .05). In adjusted analysis, the average predicted daily risk of CLABSIs after PICC insertion increased during the first 2 weeks after PICC insertion and remained elevated for the dwell time of the catheter. There was an increased risk of CLABSIs in neonates with concurrent PICCs (adjusted incidence rate ratio 2.04, 1.12-3.71). The incidence of Gram-negative CLABSIs was greater in PICCs with dwell times .50 days (incidence rate ratio 5.26, 2.40-10.66). CONCLUSIONS:The risk of CLABSIs increased during the 2 weeks after PICC insertion and then remained elevated until PICC removal. Clinicians should review PICC necessity daily, optimize catheter maintenance practices, and investigate novel CLABSI prevention strategies in PICCs with prolonged dwell times. Pediatrics 2013;132:e1609-e1615 AUTHORS:

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“…[1][2][3][4] A prospective cohort study of 19 NICUs in Japan over a 2-year period reported an incidence of 0.1%. 1 In a nationwide survey from Britain, the incidence of pericardial effusion or cardiac tamponade was 0.18%.…”

mentioning

confidence: 99%

Acute Cardiorespiratory Deterioration in a Preterm Infant

Kaluarachchi

Klein

2015

Hospital Pediatrics

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Complications of peripherally inserted central venous catheter in Japanese neonatal intensive care units

Abstract: The incidence of cardiac tamponade was rare in this multicenter prospective study. Longer duration and proximal placement may be risk factors for PICC complications. In this cohort, the CR-BSI rate was low irrespective of the degree of barrier precautions at insertion.

Cited by 59 publications

References 22 publications

PICCing Your Way into the Pericardium: A Potential Catastrophic Complication of a PICC Line

PICCing Your Way into the Pericardium: A Potential Catastrophic Complication of a PICC Line

Catheter Dwell Time and CLABSIs in Neonates With PICCs: A Multicenter Cohort Study

Acute Cardiorespiratory Deterioration in a Preterm Infant

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