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Mechanical stimulation is a risk factor for phlebitis associated with peripherally inserted central venous catheter in neonates
Author(s) -
Igarashi Aiko,
Okuno Takashi,
Shimizu Tatsuto,
Ohta Genrei,
Ohshima Yusei
Publication year - 2021
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.14476
Subject(s) - medicine , palpation , discontinuation , peripherally inserted central catheter , incidence (geometry) , surgery , catheter , neonatal intensive care unit , anesthesia , pediatrics , physics , optics
Background Our peripherally inserted central venous catheter (PICC) management plan for neonates previously included routine inspection for swelling and induration of the insertion site of a PICC using palpation. However, we discontinued routine palpation from July 13, 2018, owing to a peculiarly high incidence of PICC‐related phlebitis. The aim of this study was to prove that routine palpation was the cause of PICC‐related phlebitis. Methods We retrospectively reviewed medical records of infants who were admitted to the neonatal intensive care unit and underwent PICC placement from January 2018 to January 2019. The infants were classified into palpating (before July 13, 2018) and non‐palpating (after or on July 13, 2018) groups. We analyzed and compared the incidence of PICC‐related phlebitis in the two groups. Results Phlebitis related to PICC was more frequently observed in the palpating group (10/29 infants, 34.5%) than in the non‐palpating group (1/31, 3.2%) ( P = 0.002). After discontinuation of routine palpating in PICC management, the frequency of non‐scheduled removal of the PICC due to phlebitis decreased. The indwelling period was significantly longer in the non‐palpating group than in the palpating group. Conclusions Our results suggest that mechanical stimulation using palpation of the insertion site was the cause of PICC‐related phlebitis, resulting in early non‐scheduled removal.