Predictors of Nonelective Removal of Peripherally Inserted Central Catheters in Infants

• Published in: Biological research for nursing 2016-03, Vol.18 (2), p.173-180
• Main Authors: Costa, Priscila, Kimura, Amélia Fumiko, Brandon, Debra Huffman, Damiani, Lucas Petri
• Format: Article
• Language: English
• Subjects: Brazil; Catheter-Related Infections - etiology; Catheter-Related Infections - prevention & control; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - nursing; Catheterization, Central Venous - statistics & numerical data; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - nursing; Catheterization, Peripheral - statistics & numerical data; Cohort Studies; Device Removal - statistics & numerical data; Female; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Male; Nursing; Prospective Studies; Risk Factors
• ISSN: 1099-8004; 1552-4175
• DOI: 10.1177/1099800415590856

Background: Nonelective removal of peripherally inserted central catheters (PICCs) due to complications continues to be a major concern in neonatal intensive care units (NICUs) around the world. Nonelective removal results in interruption of intravenous therapy, added costs, stress, and negative impacts on infant’s health. Identification of predictors of complications that lead to nonelective removal of PICCs would allow for the initiation of preventive strategies to improve the quality of care. Aim: To identify predictors of nonelective removal of PICCs in neonates. Methods: A prospective cohort study with a sample of 524 PICC lines inserted in 436 neonates admitted to a tertiary-level NICU of a Brazilian hospital. Data were collected on all neonates between August 31, 2010, and August 30, 2012. Neonates were monitored daily from insertion of the catheter until its removal. Bivariate analysis and a logistic regression were conducted in order to identify predictors of nonelective removal. Results: A diagnosis of a transitory metabolic disorder (hypoglycemia; disorders of calcium, magnesium, sodium, or potassium; or dehydration), previous PICC line insertion, insertion of dual-lumen polyurethane PICC, noncentral tip position, and multiple intravenous solutions in a single-lumen silicone PICC were predictors of nonelective removal of PICC lines. Conclusion: The avoidance of repeated PICC insertions, noncentral tip position, and placement of single-lumen silicone PICCs for administration of four or more intravenous solutions is suggested. Interventions should be explored that facilitate PICC insertion success and correct tip placement.