title: Association between Peripherally Inserted Central Venous Catheter Insertion Site and Complication Rates in Preterm Infants.
abstract: Objective To examine whether there is an association between peripherally inserted central venous catheter (PICC) insertion site and complication rates among preterm infants. Design We performed a retrospective analysis of the first PICCs placed in preterm infants in a tertiary neonatal intensive care unit between January 2006 and December 2010. The PICC-related complications resulting in catheter removal were compared based on site of insertion. Results Of the 827 PICCs, 593 (72%) were inserted in upper extremity. Lower extremity PICC group infants had higher illness severity (SNAP-II) score and more likely to be inserted later as compared with the upper extremity group. There was no significant difference in the total PICC-related complications between upper and lower extremity PICCs (31.3 vs. 26%; p > 0.05). Logistic regression analysis after adjusting for gestational age, day of line insertion, and SNAP-II score revealed that upper extremity PICCs were associated with increased risk of line infiltration (adjusted odds ratio [aOR], 2.41; 95% confidence interval [CI], 1.36-4.29) but not the total PICC complication (aOR, 1.29; 95% CI, 0.91-1.83). Conclusion There is no difference in total PICC-related complication between upper and lower extremity PICCs; however, the PICC-related mechanical complications vary depending on the site of insertion in preterm infants.
authors.affiliation: Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada.
authors.forename: Rani A
authors.initials: RA
authors.lastname: Bashir
authors.affiliation: Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada.
authors.forename: Kamala
authors.initials: K
authors.lastname: Swarnam
authors.affiliation: Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada.
authors.forename: Sakeer
authors.initials: S
authors.lastname: Vayalthrikkovil
authors.affiliation: Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Yee
authors.affiliation: Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, Calgary, Alberta, Canada.
authors.forename: Amuchou S
authors.initials: AS
authors.lastname: Soraisham
mesh_terms: D000416:Alberta; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index