A Study on Peripherally Inserted Central Venous Catheter in Neonates In Tertiary Care Centre In Maharashtra

Abstract

Background: Peripherally inserted central venous catheters (PICC) have been extensively used in neonates for administration of total parenteral nutrition (TPN). Placement of a PICC is a potentially lifesaving treatment for neonates with poor peripheral venous access and intolerance to enteral nutrition.
Aims and Objectives: To study utility and complications of PICC along with evaluation of duration of catheter and all the possible factors involving removal of catheter in neonates admitted in NICU of Krishna Hospital, Karad, Maharashta.
Material and Methods: Study design: hospital based observational study. Sample size:47. Study setting: NICU of KRISHNA HOSPITAL, KARAD. Study period: February 2020 to August 2022. Data analysis: SPSS software using relevant statistical method. Descriptive statistics was performed in terms of mean, standard deviation, frequency and percentage. Analytical statistics was done to check the statistical significance.
Results: Total 47 PICC lines were inserted in 47 neonates. Out of 47 neonates with PICC line, 40% were term neonates and 60% were preterm neonates. Median gestational age for PICC line insertion is 30.85 weeks minimum being 26 weeks and maximum being 38 wks. Out of 42.6% were extremely low birth weight (ELBW) ,46.8% were very low birth weight (VLBW), 8.5%were low birth weight (LBW). Mean birth weight of the participants was 1.18 ± 0.32 kgs. In most of the cases PICC line was inserted at 1st attempt (80.8%). Majority of neonates (68.1%) received Infusion of IV fluids, Antibiotics and Aminoven. In most of the patients PICC line was inserted in right long saphenous vein (87.2%). Reason for removal of PICC line was due to achievement of full feed and weight gain (72.4%). The mean catheter duration in our study was 18 days. Total 16 complications were noted. Most common complication observed was Catheter Associated Blood Stream Infection in 14.9% patients followed by Necrotising enterocolitis in 6.3% patients. In our study, out 47 neonates with PICC line, 31 neonates (66%) with PICC line have no complication.Out of 47 patient, 39 neonates (83.1%) were discharged , 4 (8.5%) were expired, 2 (4.3%) were referred to higher center and LAMA each.
Conclusion: PICC line has become a vital mode of providing medication to neonates especially in extreme preterm neonates. Hence it is important to recognize its utility, complication, durability and factors involved in removal of catheter.