title: Peripherally inserted central catheter in neonates: A safe and easy insertion technique.
abstract: OBJECTIVE
  Peripherally inserted central catheters (PICC) are used extensively in neonates. However, insertion of these thinnest catheters is a very delicate procedure. We developed an easy and safe insertion technique for 2-French (F) PICCs with a new fine-tipped introducer cannula created without modifying commercial products by advancing a 24-gauge peripheral venous cannula through a half-peeled (20-gauge) introducer cannula. We evaluated neonates treated with our new PICC insertion technique.
  
  
  METHODS
  Information was collected retrospectively on all 32 2-F PICCs inserted during the 4-year period from November 2010 to November 2014. We monitored neonates, recording the success rate of placement, number of insertion attempts, reasons for removal, and complications.
  
  
  RESULTS
  In total, 32 2-F PICCs were placed in 31 patients (19 (61%) males and 12 (39%) females; median age 7 (range: 1-36) days, median weight 2200 (range: 800-4100) g) using the new technique. The vein accessed most commonly was the long saphenous vein (87%). The duration of catheterization was 10.3 ± 4.2 days. Almost all PICCs were inserted successfully (32/33, success rate 97%) and in the first venipuncture (28/32, 88%). Of the PICCs, 81% were removed after completion of therapy or upon death. Two minor bleeding complications were noted at the insertion site.
  
  
  CONCLUSIONS
  This novel technique is an easy and safe way of inserting a 2-F PICC in neonates. It can be used by anyone in a neonatal unit who can insert a 24-gauge peripheral venous access.
authors.affiliation: Department of Pediatric Surgery, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey. Electronic address: iuygun@hotmail.com.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Uygun
mesh_terms: D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018962:Phlebotomy; D012189:Retrospective Studies
keywords: Catheter insertion; Fine-tipped; Introducer; Peripherally inserted central catheter; Technique; Vascular access