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Complications of peripherally inserted central venous catheter in J apanese neonatal intensive care units
Author(s) -
Ohki Yasushi,
Maruyama Kenichi,
Harigaya Akira,
Kohno Miyuki,
Arakawa Hirokazu
Publication year - 2013
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12033
Subject(s) - medicine , catheter , odds ratio , peripherally inserted central catheter , confidence interval , prospective cohort study , incidence (geometry) , central venous catheter , tamponade , intensive care , surgery , cohort study , pericardial effusion , cohort , intensive care medicine , physics , optics
Background The aim of this study was to investigate the incidence and risk factors of peripherally inserted central venous catheter ( PICC )‐related complications using a multicenter case survey. Method A prospective cohort study was carried out by 19 neonatal intensive care units ( NICUs) in J apan from F ebruary 2005 to M arch 2007. A total of 975 case records were collected. PICC ‐related complications including pericardial effusion/cardiac tamponade pleural effusion/ascites, catheter removal difficulties, catheter‐related bloodstream infection ( CR‐BSI ), and symptomatic catheter‐related thrombosis were collected from case record forms. As for precautions during insertion, institutions were classified into three groups: those with maximum barrier precautions; standard precautions; and no specific precautions. Results PICC complications occurred in 27 cases (2.9%) among 946 PICC . The incidence was 1.6% for CR‐BSI , and 0.1% for cardiac tamponade. C R‐BSI rate per 1000 catheter‐days was 1.1 with maximum barrier precautions at catheter insertion, 1.2 with standard precautions, and 1.8 with no specific precautions. Multiple logistic regression analysis showed that proximal placement (odds ratio [ OR] , 3.88; 95% confidence interval [ CI]: 1.42–10.60, P = 0.008) and longer placement duration ( OR , 1.35; 95% CI : 1.14–1.60, for each week, P = 0.0005) independently contributed to overall complications. Conclusion The incidence of cardiac tamponade was rare in this multicenter prospective study. Longer duration and proximal placement may be risk factors for PICC complications. In this cohort, the CR‐BSI rate was low irrespective of the degree of barrier precautions at insertion.