Dwell times and risk of non-elective removal of 1-French peripherally inserted central catheters according to catheter tip position in very preterm infants

Abstract

We investigated dwell times and risk of non-elective removal of 975 single-lumen 1-French peripherally inserted central catheters (1FR-PICC) according to tip position in a cohort of very preterm infants with a mean (SD) gestational age of 27⁺⁶ (2⁺¹) weeks and a mean (SD) birth weight of 988 (294) g over an eight-year period. Infants with a 1FR-PICC inserted for continuous infusion of intravenous fluids within the first 30 days of life were eligible. Dwell times of PICC with elective versus non-elective removal, risk of non-elective removal of PICC according to tip position, and differences between upper versus lower limb catheter insertion were analysed. 33.8% PICC were removed non-electively. Median (IQR) dwell time was 193 (142–287) versus 154 (102–260) h for elective versus non-elective removal (p < 0.001). Non-elective removal was more common for lower limb insertion sites: 41 versus 31% (p = 0.002). PICC were significantly more likely to be removed non-electively when located in the axillary (odds ratio (OR) 2.08), cephalic (OR 8.93), external iliac (OR 4.99), and femoral (OR 10.31) vein.

Conclusion: In this cohort, dwell times of 1FR-PICC lines removed non-electively were similar to 1.9- or 2.0FR-PICC. PICC tips positioned in the axillary, cephalic, external iliac, and femoral veins had a higher risk of non-elective removal.

What is Known:

•Peripherally inserted central catheters (PICC) are widely used in neonatal intensive care.

•Previous studies focused on 2-French PICC and newborns of all gestational ages.

What is New:

•Dwell times of 1-French PICC removed non-electively were similar to 2-French PICC.

•1-French PICC tips positioned more peripherally had a higher risk of non-elective removal.

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