title: Assessment of infants with peripherally inserted central catheters: Part 2. Detecting less frequently occurring complications.
abstract: Peripherally inserted central catheters (PICCs) are frequently placed in neonates to optimize nutrition and provide stable infusions of critical medications into the central vascular system. PICCs have been associated with a number of device-specific complications that can manifest during insertion, while the line is indwelling, and/or after the removal of the line. The first article of this series in Focus on the Physical, titled "Assessment of Infants With Peripherally Inserted Central Catheters: Part I. Detecting the Most Frequently Occurring Complications," presented assessment strategies to detect common complications such as catheter occlusions and catheter-related bloodstream infections. Part 2 of this series emphasizes the importance of ongoing systematic assessment of PICCs for device-specific complications such as catheter migration, dislodgement, breakage, phlebitis, and thrombosis, as well as the life-threatening complications of pleural and pericardial effusion and tamponade. Each complication is described, along with a review of the etiology, a description of presenting signs and symptoms, and key clinical interventions.
authors.affiliation: Neonatal Intensive Care Unit, Doctors Medical Center, 1441 Florida Ave, Modesto, CA 95350, USA. Janet.Pettit@tenethealth.com
authors.forename: Janet
authors.initials: J
authors.lastname: Pettit
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000451:nursing; D002305:Cardiac Tamponade / Q000209:etiology / Q000451:nursing; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004868:Equipment Failure; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology / Q000451:nursing; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology / Q000451:nursing; D006801:Humans; D007231:Infant, Newborn; D017283:Neonatal Nursing / Q000379:methods*; D009730:Nursing Assessment / Q000379:methods*; D010490:Pericardial Effusion / Q000209:etiology / Q000451:nursing; D010689:Phlebitis / Q000209:etiology / Q000451:nursing; D010996:Pleural Effusion / Q000209:etiology / Q000451:nursing; D020246:Venous Thrombosis / Q000209:etiology / Q000451:nursing