title: Peripherally inserted central venous catheter-associated complications exert negative effects on body weight gain in neonatal intensive care units.
abstract: OBJECTIVE
  The placement of a peripherally inserted central venous catheter (PICC) is an essential procedure in neonatal intensive care units (NICU). The aim of this study was to determine the risk of PICC complications in NICU, and further identify the effects of PICC complications on body weight gain in premature infants.
  
  
  METHODS
  A total of 304 premature infants who had a PICC inserted in NICU were enrolled in this study. The weight-for-age z-score (WAZ) at the time of PICC insertion and removal were calculated, and changes of WAZ in different groups were compared using a t-test. Risk factors for PICC complications were assessed using the chi-squared test and multiple logistic regression analysis.
  
  
  RESULTS
  Thirty (9.97%) PICCs were removed due to complications. Of them, 14 PICCs were removed because of non-infectious complications and 16 PICCs were removed for central-line-associated bloodstream infections (CLABSIs). Multiple logistic regression analysis showed that premature infants with birth weight >1,500 g were less likely to have PICC complications than infants with birth weight <=1,500 g (OR, 0.29; 95% CI: 0.10-0.82; p=0.020). In addition, the changes in WAZ between PICC insertion and removal were significantly different in both infectious (-0.144±0.122, p<0.005) and non-infectious (-0.65±0.528, p<0.001) complications groups, compared with the no complications group (0.291±0.552).
  
  
  CONCLUSIONS
  Findings from this study suggest that birth weight is a risk factor for PICC-associated complications in the NICU, and both infectious and non-infectious PICC complications are associated with poor body weight gain in premature infants.
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.|Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.|Shanghai Institute of Pediatric Research, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of Nursing, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Nursing, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Niannian
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shourong
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Email: caiw1978@163.com.|Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.|Shanghai Institute of Pediatric Research, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
mesh_terms: D001424:Bacterial Infections / Q000209:etiology; D001724:Birth Weight; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods; D062905:Central Venous Catheters / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D018529:Nutritional Support / Q000379:methods; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000382:microbiology; D015430:Weight Gain