title: Dwell times and risk of non-elective removal of 1-French peripherally inserted central catheters according to catheter tip position in very preterm infants.
abstract: We investigated dwell times and risk of non-elective removal of 975 single-lumen 1-French peripherally inserted central catheters (1FR-PICC) according to tip position in a cohort of very preterm infants with a mean (SD) gestational age of 27+6(2+1) weeks and a mean (SD) birth weight of 988 (294) g over an eight-year period. Infants with a 1FR-PICC inserted for continuous infusion of intravenous fluids within the first 30 days of life were eligible. Dwell times of PICC with elective versus non-elective removal, risk of non-elective removal of PICC according to tip position, and differences between upper versus lower limb catheter insertion were analysed. 33.8% PICC were removed non-electively. Median (IQR) dwell time was 193 (142-287) versus 154 (102-260) h for elective versus non-elective removal (p < 0.001). Non-elective removal was more common for lower limb insertion sites: 41 versus 31% (p = 0.002). PICC were significantly more likely to be removed non-electively when located in the axillary (odds ratio (OR) 2.08), cephalic (OR 8.93), external iliac (OR 4.99), and femoral (OR 10.31) vein.
  
  
  CONCLUSIONS
  In this cohort, dwell times of 1FR-PICC lines removed non-electively were similar to 1.9- or 2.0FR-PICC. PICC tips positioned in the axillary, cephalic, external iliac, and femoral veins had a higher risk of non-elective removal. What is Known: •Peripherally inserted central catheters (PICC) are widely used in neonatal intensive care. •Previous studies focused on 2-French PICC and newborns of all gestational ages. What is New: •Dwell times of 1-French PICC removed non-electively were similar to 2-French PICC. •1-French PICC tips positioned more peripherally had a higher risk of non-elective removal.
authors.affiliation: Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia.
authors.forename: Daniela M
authors.initials: DM
authors.lastname: Erhard
authors.affiliation: Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nguyen
authors.affiliation: Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia.
authors.forename: Katelyn J
authors.initials: KJ
authors.lastname: Guy
authors.affiliation: Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Casalaz
authors.affiliation: Department of Paediatrics, Mercy Hospital for Women, 163 Studley Road, Melbourne, VIC, 3084, Australia. kaikonig@gmail.com.
authors.forename: Kai
authors.initials: K
authors.lastname: König
mesh_terms: D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D020878:Device Removal / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors
keywords: Peripherally inserted central catheter; Preterm infants