title: Complications associated with 2 different types of percutaneously inserted central venous catheters in very low birth weight infants.
abstract: OBJECTIVE
  To identify the prevalence and risk factors for complications associated with percutaneously inserted central venous catheters (PICCs) and evaluate the effect of different catheter types and their indwelling time on catheter-related complications.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A 49-bed neonatal intensive-care teaching hospital in Taiwan.
  
  
  METHODS
  Between 2004 and 2007, 518 single-lumen PICCs (defined as "old type") and 290 PICCs with a stiffening stylet and a thicker introducer ("new type") were inserted in a total of 534 neonates with a birth body weight of 1,500 g or less.
  
  
  RESULTS
  Independent risk factors of catheter-related sepsis (CRS) were longer duration for PICC placement and PICC inserted at femoral site (compared with nonfemoral sites) (odds ratio [OR], 1.53 [95% confidence interval {CI}, 1.07-2.25]; P = .044). An independent predictor of catheter-related noninfectious complications was time spent for PICC insertion of more than 60 minutes (compared with less than 30 minutes) (OR, 1.96 [95% CI, 1.08-3.53]; P = .026). New-type PICCs were significantly associated with a higher rate of femoral site insertion, catheter-related noninfectious complications, and longer time for successful insertion than old-type PICCs. The hazard rates of CRS according to indwelling time, determined over 5-day periods by survival analysis, showed 0.05% for catheters in place for 4 days or less; 0.27% for 5-9 days; 0.40% for 10-14 days; 0.68% for 15-19 days; 1.18% for 20-24 days; 3.96% for 25-29 days; and 10.45% for 30 or more days.
  
  
  CONCLUSIONS
  Different catheters do influence the complication rates. Spending more than 60 minutes for successful PICC insertion and PICCs indwelling for more than 30 days are associated with higher rates of catheter-related complications.
authors: Division of Neonatology and Pediatric Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan.
authors: Ming-Horng
authors: MH
authors: Tsai
authors: Shih-Ming
authors: SM
authors: Chu
authors: Reyin
authors: R
authors: Lien
authors: Hsuan-Rong
authors: HR
authors: Huang
authors: Jiunn-Wei
authors: JW
authors: Wang
authors: Chiao-Ching
authors: CC
authors: Chiang
authors: Jen-Fu
authors: JF
authors: Hsu
authors: Yhu-Chering
authors: YC
authors: Huang
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D057785:Catheters / Q000009:adverse effects*; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal / Q000379:methods; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors