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.

中文翻译：

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新生儿外周置入中心导管并发症的危险因素

客观的

确定与非选择性 PICC 切除和并发症相关的因素。

学习规划

总体而言，1234 个 PICC 被放置在 918 名月经后年龄小于 45 周的住院婴儿中。研究的结果包括非选择性 PICC 移除（在治疗完成前移除）和线路并发症。进行单变量和多变量混合效应逻辑回归分析以评估潜在预测变量与临床结果之间的关联

结果

非选择性 PICC 切除发生率为 28.4%，并发症发生率为 34.4%。非选择性切除 ( p  < 0.001) 和并发症 ( p  = 0.006) 更常见于上肢 PICC。前 72 小时 ( p  = 0.0009) 和随时间推移 ( p  = 0.0003) 的错位在上肢 PICCS 中更常见；然而，上肢 PICC 与静脉炎、水肿和灌注变化的发生率降低相关（p  = 0.03）。

结论

大约三分之一的 PICC 与并发症有关。在可行的情况下，应放置下肢 PICC，因为它们可能与较少的并发症相关。