Insertion of peripherally inserted central catheters in neonates less than 1.5 kg using ultrasound guidance

Pediatr Surg Int. 2016 Nov;32(11):1053-1057. doi: 10.1007/s00383-016-3959-1. Epub 2016 Sep 2.

Abstract

Background: Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes.

Methods: A retrospective chart review was conducted of all patients below 1500 g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center. All patients had multiple previous attempts at PICC placement by experienced NICU vascular access nurses prior to referral. Complications were determined based on clinical and procedural notes.

Results: A total of ten patients were found during the study period. The average estimated gestational age was 29.8 weeks (range 26-38 weeks).The average weight at the time of PICC insertion was 968 g (range 485-1390 g). All attempts at placement were successful. There were no complications directly related to PICC insertion.

Conclusion: Ultrasound guided PICC line placements using ultrasound is an effective technique, which can be applied to very low and extremely low birth weight infants, with excellent success rates and a low risk of complications.

Keywords: Central access; Neonate; Pediatric; Ultrasound.

MeSH terms

  • Catheterization, Peripheral / instrumentation*
  • Catheterization, Peripheral / methods*
  • Catheters, Indwelling
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • Retrospective Studies
  • Ultrasonography, Interventional / methods*