Indicações e complicações de cateteres centrais de inserção periférica em recém-nascidos pré-termos de muito baixo peso

Abstract

Introduction: Peripherally inserted central catheters (PICCs) are devices that are used for venous access in neonates. Despite the benefits of PICCs, there may be complications related to their insertion and maintenance. Objective: The objective of the present study was to identify the indications and complications of PICCs. Design: This prospective study included 44 neonates with birth weights less than or equal to 1,500 grams and gestational ages less than 37 weeks who underwent 52 PICC insertions between June 2011 and January 2012. A form was used to collect data on the characteristics of the neonates, including clinical indications for PICC insertion, PICC insertion location and positioning, length of PICC usage, complications and PICC removal. Main results: Prolonged intravenous therapy (94.2% of PICCS), especially involving parenteral nutrition and antimicrobial use, were the main indications for PICC insertion. The neonates had an average age of 5.18 days at the time of PICC insertion, and 38.5% of the PICCs were inserted into neonates aged between 4 and 6 days. The cephalic vein was the most common vessel used for insertions (48.1%). The most frequent complications were mispositioning (67.3%), sepsis (21.1%), difficult progression of the catheter during insertion (17.3%), post-insertion bleeding (9.6%) and signs of inflammation (9.6%). Accidental exits were infrequent. Conclusions: Monitoring and evaluating the occurrence of PICC complications and training the nursing staff on proper PICC handling ensures the safe and effective handling of preterm neonates with very low birth weight.