Effect of heparin and other factors associated with complications of peripherally inserted central venous catheters in neonates.
OBJECTIVE
To identify factors associated with complications necessitating unplanned removal of peripherally inserted central venous catheters (PICCs) in neonates.


METHODS
A before-and-after comparison following the exclusion of heparin from continuous infusions through PICCs placed by a designated team. Duration of use was assessed during epochs immediately preceding and following the practice change. Multivariable logistic regression was performed to identify independent risk factors associated with unplanned catheter removal.


RESULTS
We analyzed 189 PICC placements with heparin (epoch 1) and 188 with no heparin (epoch 2) added to infusions. Rates of complication (23.7 vs 17.2 per 1000 catheter days) and median durations of use (7 vs 8 days) did not differ significantly between the epochs. Non-central position of the catheter tip, use of dual lumen catheters and placement through the cephalic vein were independently associated with complications (each P<0.05).


CONCLUSIONS
In neonates requiring short-term intravenous access, heparin may be safely omitted from continuous infusions without compromising catheter usability.
Department of Pharmacy, UCHealth University Hospital, Cincinnati, OH, USA. barbara.isemann@uchealth.com
B
B
Isemann
R
R
Sorrels
H
H
Akinbi
D000925:Anticoagulants / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D062905:Central Venous Catheters; D004867:Equipment Design; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D016015:Logistic Models; D012307:Risk Factors
D000925:Anticoagulants; D006493:Heparin