Gillian C Pet1, Jens C Eickhoff2, Kate E McNevin3, Julie Do3, Ryan M McAdams4. 1. Division of Neonatal-Perinatal Medicine, Washington University School of Medicine, St. Louis, MO, USA. gpet@wustl.edu. 2. Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA. 3. University of Washington School of Medicine, Seattle, WA, USA. 4. Division of Neonatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Abstract
OBJECTIVE: To determine factors associated with nonelective PICC removal and complications. STUDY DESIGN: Overall, 1234 PICCs were placed in 918 hospitalized infants <45 weeks postmenstrual age. Outcomes studied include nonelective PICC removal (removal prior to completion of therapy) and line complications. Univariate and multivariate mixed-effects logistic regression analyses were conducted to evaluate the associations between potential predictor variables and clinical outcomes RESULTS: Nonelective PICC removal occurred in 28.4% and complications in 34.4% of infants. Nonelective removal (p < 0.001) and complications (p = 0.006) occurred more often with upper than lower extremity PICCs. Malposition in the first 72 h (p = 0.0009) and over time (p = 0.0003) were more common in upper extremity PICCS; however, upper extremity PICCs were associated with a decreased incidence of phlebitis, edema, and perfusion changes (p = 0.03). CONCLUSIONS: Approximately one-third of PICCs were associated with complications. When feasible, lower extremity PICCs should be placed as they may be associated with fewer complications.
OBJECTIVE: To determine factors associated with nonelective PICC removal and complications. STUDY DESIGN: Overall, 1234 PICCs were placed in 918 hospitalized infants <45 weeks postmenstrual age. Outcomes studied include nonelective PICC removal (removal prior to completion of therapy) and line complications. Univariate and multivariate mixed-effects logistic regression analyses were conducted to evaluate the associations between potential predictor variables and clinical outcomes RESULTS: Nonelective PICC removal occurred in 28.4% and complications in 34.4% of infants. Nonelective removal (p < 0.001) and complications (p = 0.006) occurred more often with upper than lower extremity PICCs. Malposition in the first 72 h (p = 0.0009) and over time (p = 0.0003) were more common in upper extremity PICCS; however, upper extremity PICCs were associated with a decreased incidence of phlebitis, edema, and perfusion changes (p = 0.03). CONCLUSIONS: Approximately one-third of PICCs were associated with complications. When feasible, lower extremity PICCs should be placed as they may be associated with fewer complications.
Authors: Mohammad A A Bayoumi; Roland van Rens; Prem Chandra; Deena Shaltout; Ashraf Gad; Einas E Elmalik; Samer Hammoudeh Journal: BMJ Open Date: 2022-04-06 Impact factor: 2.692