title: Incidence of nonelective removal of percutaneously inserted central catheters according to tip position in neonates.
abstract: OBJECTIVE
  To compare the incidence and reasons for nonelective removal of percutaneously inserted central catheters (PICC lines) between centrally and noncentrally placed PICC lines in neonates.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A 60-bed, tertiary-level neonatal intensive care unit in a private hospital in São Paulo, Brazil.
  
  
  METHODS
  Neonates who were born at the hospital and underwent successful insertion of 237 PICC lines. They were divided into two groups, central and noncentral, according to tip position.
  
  
  METHODS
  Neonates were monitored daily from insertion of the PICC until its removal. Data were collected from medical records.
  
  
  RESULTS
  Of the 237 PICCs analyzed, 207 (87.4%) had their tip in a central position and 30 (12.6%) in a noncentral position. The incidence of nonelective PICC removal was similar between the central and noncentral groups (p = .48). The reasons for nonelective removal were significantly different between the groups (p = .007), with a higher incidence of extravasation in the noncentral group.
  
  
  CONCLUSIONS
  Noncentrally placed PICCs can provide vascular access in neonates requiring venous access for the administration of intravenous solutions. Many potential catheter-related complications can be prevented by careful bedside nursing. Frequent monitoring of noncentral PICCs is necessary to detect and prevent extravasation in neonates.
authors.affiliation: Department of Maternal-Child and Psychiatric Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil. priscila2.costa@usp.br
authors.forename: Priscila
authors.initials: P
authors.lastname: Costa
authors.forename: Mariana
authors.initials: M
authors.lastname: Bueno
authors.forename: Angelina Maria Aparecida
authors.initials: AM
authors.lastname: Alves
authors.forename: Amélia Fumiko
authors.initials: AF
authors.lastname: Kimura
mesh_terms: D001938:Brazil; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000451:nursing / Q000706:statistics & numerical data*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation / Q000451:nursing / Q000706:statistics & numerical data*; D057785:Catheters / Q000009:adverse effects / Q000706:statistics & numerical data*; D015331:Cohort Studies; D020878:Device Removal / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D017283:Neonatal Nursing / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies