Abstract Peripherally inserted central catheter (PICC) has been widely used in the neonatal intensive care unit (NICU) in recent years, but there are potential risks for complications related to PICC. Based on the current evidence in China and overseas, the operation and management guidelines for PICC in neonates were developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) in order to help the NICU staff to regulate the operation and management of PICC.
Jin JF, Chen CF, Zhao RY, et al. Repositioning techniques of malpositioned peripherally inserted central catheters[J]. J Clin Nurs, 2013, 22(13-14):1791-1804.
[4]
Singh A, Bajpai M, Panda SS, et al. Complications of peripherally inserted central venous catheters in neonates:lesson learned over 2 years in a tertiary care centre in India[J]. Afr J Paediatr Surg, 2014, 11(3):242-247.
[5]
Gilbert R, Brown M, Rainford N, et al. Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL):an open-label, parallel-group, pragmatic, randomised controlled trial[J]. Lancet Child Adolesc Health, 2019, 3(6):381-390.
[6]
Jumani K, Advani S, Reich NG, et al. Risk factors for peripherally inserted central venous catheter complications in children[J]. JAMA Pediatr, 2013, 167(5):429-435.
Baggio MA, Bazzi FC, Bilibio CA. Peripherally inserted central catheter:description of its use in neonatal and pediatric ICU[J]. Rev Gaucha Enferm, 2010, 31(1):70-76.
[9]
Ohki Y, Maruyama K, Harigaya A, et al. Complications of peripherally inserted central venous catheter in Japanese neonatal intensive care units[J]. Pediatr Int, 2013, 55(2):185-189.
[10]
Organization World Health. WHO Handbook for Guideline Development[EB/OL].[2020-07-16]. https://apps.who.int/iris/bitstream/handle/10665/145714/9789241548960_eng.pdf?sequence=1&isAllowed=y.
[11]
Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182(18):E839-E842.
Chen YL, Yang KH, Marušic A, et al. A reporting tool for practice guidelines in health care:the RIGHT statement[J]. Ann Intern Med, 2017, 166(2):128-132.
BMJ Best Practice. Premature newborn care[EB/OL].[2020-07-16]. https://bestpractice.bmj.com/topics/en-us/671/pdf/671/Premature%20newborn%20care.pdf.
[18]
National Institute for Health and Care Excellence. Neonatal parenteral nutrition[EB/OL].[2020-07-16]. https://www.nice.org.uk/guidance/ng154/resources/neonatal-parenteral-nutrition-pdf-66141840283333.
[19]
National Association of Neonatal Nurses. Peripherally inserted central catheters:guideline for practice, 3rd edition[EB/OL].[2020-07-16].
[20]
Gazitua R, Wilson K, Bistrian BR, et al. Factors determining peripheral vein tolerance to amino acid infusions[J]. Arch Surg, 1979, 114(8):897-900.
[21]
Kuwahara T, Asanami S, Tamura T, et al. Effects of pH and osmolality on phlebitic potential of infusion solutions for peripheral parenteral nutrition[J]. J Toxicol Sci, 1998, 23(1):77-85.
[22]
Boullata JI, Gilbert K, Sacks G, et al. A.S.P.E.N. clinical guidelines:parenteral nutrition ordering, order review, compounding, labeling, and dispensing[J]. JPEN J Parenter Enteral Nutr, 2014, 38(3):334-377.
[23]
李全磊. PICC置管前评估的临床实践指南构建[D]. 上海:复旦大学, 2012.
[24]
Queensland Government. Guideline:peripherally inserted central venous catheters (PICC)[EB/OL].[2020-07-16]. https://www.health.qld.gov.au/__data/assets/pdf_file/0032/444497/icare-picc-guideline.pdf.
[25]
O'grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections[J]. Clin Infect Dis, 2011, 52(9):e162-e193.
[26]
Legemaat MM, Jongerden IP, van Rens RM, et al. Effect of a vascular access team on central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit:a systematic review[J]. Int J Nurs Stud, 2015, 52(5):1003-1010.
[27]
Cooley K, Grady S. Minimizing catheter-related bloodstream infections:one unit's approach[J]. Adv Neonatal Care, 2009, 9(5):209-226.
[28]
Curry S, Honeycutt M, Goins G, et al. Catheter-associated bloodstream infections in the NICU:getting to zero[J]. Neonatal Netw, 2009, 28(3):151-155.
[29]
Golombek SG, Rohan AJ, Parvez B, et al. "Proactive" management of percutaneously inserted central catheters results in decreased incidence of infection in the ELBW population[J]. J Perinatol, 2002, 22(3):209-213.
[30]
Holzmann-Pazgal G, Kubanda A, Davis K, et al. Utilizing a line maintenance team to reduce central-line-associated bloodstream infections in a neonatal intensive care unit[J]. J Perinatol, 2012, 32(4):281-286.
Yoo S, Ha M, Choi D, et al. Effectiveness of surveillance of central catheter-related bloodstream infection in an ICU in Korea[J]. Infect Control Hosp Epidemiol, 2001, 22(7):433-436.
[33]
Warren DK, Zack JE, Cox MJ, et al. An educational intervention to prevent catheter-associated bloodstream infections in a nonteaching, community medical center[J]. Crit Care Med, 2003, 31(7):1959-1963.
[34]
Warren DK, Zack JE, Mayfield JL, et al. The effect of an education program on the incidence of central venous catheter-associated bloodstream infection in a medical ICU[J]. Chest, 2004, 126(5):1612-1618.
[35]
Eggimann P, Harbarth S, Constantin MN, et al. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care[J]. Lancet, 2000, 355(9218):1864-1868.
[36]
Kolaček S, Puntis JWL, Hojsak I, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition:venous access[J]. Clin Nutr, 2018, 37(6 Pt B):2379-2391.
[37]
Jacob JT, Gaynes R. Intravascular catheter-related infection:prevention[EB/OL].[2020-07-16]. https://www.uptodate.com/contents/zh-Hans/intravascular-catheter-related-infection-prevention.
[38]
Blot K, Bergs J, Vogelaers D, et al. Prevention of central line-associated bloodstream infections through quality improvement interventions:a systematic review and meta-analysis[J]. Clin Infect Dis, 2014, 59(1):96-105.
O'brien J, Paquet F, Lindsay R, et al. Insertion of PICCs with minimum number of lumens reduces complications and costs[J]. J Am Coll Radiol, 2013, 10(11):864-868.
[41]
Isemann B, Sorrels R, Akinbi H. Effect of heparin and other factors associated with complications of peripherally inserted central venous catheters in neonates[J]. J Perinatol, 2012, 32(11):856-860.
[42]
Di Fiore RE. Clinical and engineering considerations for the design of indwelling vascular access devices-materials and product development overview[J]. J Assoc Vasc Access, 2005, 10(1):24-27.
[43]
Yu XH, Yue SJ, Wang MJ, et al. Risk factors related to peripherally inserted central venous catheter nonselective removal in neonates[J]. Biomed Res Int, 2018, 2018:3769376.
[44]
Chu WH. Evidence Summary. Peripherally inserted central catheter:occlusion[Z]. The Joanna Briggs Institute EBP Database, JBI@Ovid, 2017:JBI652.
[45]
Chen HX, Zhang XX, Wang H, et al. Complications of upper extremity versus lower extremity placed peripherally inserted central catheters in neonatal intensive care units:a meta-analysis[J]. Intensive Crit Care Nurs, 2020, 56:102753.
Lund CH, Osborne JW, Kuller J, et al. Neonatal skin care:clinical outcomes of the AWHONN/NANN evidence-based clinical practice guideline. Association of Women's Health, Obstetric and Neonatal Nurses and the National Association of Neonatal Nurses[J]. J Obstet Gynecol Neonatal Nurs, 2001, 30(1):41-51.
[51]
Kieran EA, O'sullivan A, Miletin J, et al. 2% chlorhexidine-70% isopropyl alcohol versus 10% povidone-iodine for insertion site cleaning before central line insertion in preterm infants:a randomised trial[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(2):F101-F106.
[52]
Aitken J, Williams FL. A systematic review of thyroid dysfunction in preterm neonates exposed to topical iodine[J]. Arch Dis Child Fetal Neonatal Ed, 2014, 99(1):F21-F28.
[53]
Garland JS, Alex CP, Uhing MR, et al. Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates[J]. J Perinatol, 2009, 29(12):808-813.
[54]
Chapman AK, Aucott SW, Milstone AM. Safety of chlorhexidine gluconate used for skin antisepsis in the preterm infant[J]. J Perinatol, 2012, 32(1):4-9.
[55]
Andersen C, Hart J, Vemgal P, et al. Prospective evaluation of a multi-factorial prevention strategy on the impact of nosocomial infection in very-low-birthweight infants[J]. J Hosp Infect, 2005, 61(2):162-167.
[56]
Neri I, Ravaioli GM, Faldella G, et al. Chlorhexidine-Induced chemical burns in very low birth weight infants[J]. J Pediatr, 2017, 191:262-265.e2.
[57]
Heron TJ, Faraday CM, Clarke P. The hidden harms of matching Michigan[J]. Arch Dis Child Fetal Neonatal Ed, 2013, 98(5):F466-F467.
[58]
Tamma PD, Aucott SW, Milstone AM. Chlorhexidine use in the neonatal intensive care unit:results from a national survey[J]. Infect Control Hosp Epidemiol, 2010, 31(8):846-849.
[59]
Kutsch J, Ottinger D. Neonatal skin and chlorhexidine:a burning experience[J]. Neonatal Netw, 2014, 33(1):19-23.
McCord H, Fieldhouse E, El-Naggar W. Current practices of antiseptic use in Canadian neonatal intensive care units[J]. Am J Perinatol, 2019, 36(2):141-147.
[62]
Upadhyayula S, Kambalapalli M, Harrison CJ. Safety of anti-infective agents for skin preparation in premature infants[J]. Arch Dis Child, 2007, 92(7):646-647.
[63]
Shime N, Hosokawa K, Maclaren G. Ultrasound imaging reduces failure rates of percutaneous central venous catheterization in children[J]. Pediatr Crit Care Med, 2015, 16(8):718-725.
[64]
Sabouneh R, Akiki P, Al Bizri A, et al. Ultrasound guided central line insertion in neonates:pain score results from a prospective study[J]. J Neonatal Perinatal Med, 2020, 13(1):129-134.
[65]
Oleti T, Jeeva Sankar M, Thukral A, et al. Does ultrasound guidance for peripherally inserted central catheter (PICC) insertion reduce the incidence of tip malposition?-a randomized trial[J]. J Perinatol, 2019, 39(1):95-101.
Sabado JJ, Pittiruti M. Principles of ultrasound-guided venous access[EB/OL].[2020-07-16]. https://www.uptodate.com/contents/principles-of-ultrasound-guided-venous-access.
[68]
Katheria AC, Fleming SE, Kim JH. A randomized controlled trial of ultrasound-guided peripherally inserted central catheters compared with standard radiograph in neonates[J]. J Perinatol, 2013, 33(10):791-794.
Kaur G, Gupta P, Kumar A. A randomized trial of eutectic mixture of local anesthetics during lumbar puncture in newborns[J]. Arch Pediatr Adolesc Med, 2003, 157(11):1065-1070.
Tang L, Wang HH, Liu QH, et al. Effect of music intervention on pain responses in premature infants undergoing placement procedures of peripherally inserted central venous catheter:a randomized controlled trial[J]. Eur J Integr Med, 2018, 19:105-109.
[74]
Bellieni CV, Tei M, Coccina F, et al. Sensorial saturation for infants' pain[J]. J Matern Fetal Neonatal Med, 2012, 25(Suppl 1):79-81.
[75]
Motz P, Von Saint Andre Von Arnim A, Iyer RS, et al. Point-of-care ultrasound for peripherally inserted central catheter monitoring:a pilot study[J]. J Perinat Med, 2019, 47(9):991-996.
[76]
Telang N, Sharma D, Pratap OT, et al. Use of real-time ultrasound for locating tip position in neonates undergoing peripherally inserted central catheter insertion:a pilot study[J]. Indian J Med Res, 2017, 145(3):373-376.
Ren XL, Li HL, Liu J, et al. Ultrasound to localize the peripherally inserted central catheter tip position in newborn infants[J]. Am J Perinatol, 2021, 38(2):122-125.
[79]
Kadivar M, Mosayebi Z, Ghaemi O, et al. Ultrasound and radiography evaluation of the tips of peripherally inserted central catheters in neonates admitted to the NICU[J]. Iran J Pediatr, 2020, 30(6):e108416.
Ling QY, Chen H, Tang M, et al. Accuracy and safety study of intracavitary electrocardiographic guidance for peripherally inserted central catheter placement in neonates[J]. J Perinat Neonatal Nurs, 2019, 33(1):89-95.
[83]
Xiao AQ, Sun J, Zhu LH, et al. Effectiveness of intracavitary electrocardiogram-guided peripherally inserted central catheter tip placement in premature infants:a multicentre pre-post intervention study[J]. Eur J Pediatr, 2020, 179(3):439-446.
[84]
Racadio JM, Doellman DA, Johnson ND, et al. Pediatric peripherally inserted central catheters:complication rates related to catheter tip location[J]. Pediatrics, 2001, 107(2):E28.
Albrecht K, Breitmeier D, Panning B, et al. The carina as a landmark for central venous catheter placement in small children[J]. Eur J Pediatr, 2006, 165(4):264-266.
[87]
Weil BR, Ladd AP, Yoder K. Pericardial effusion and cardiac tamponade associated with central venous catheters in children:an uncommon but serious and treatable condition[J]. J Pediatr Surg, 2010, 45(8):1687-1692.
[88]
Sertic AJ, Connolly BL, Temple MJ, et al. Perforations associated with peripherally inserted central catheters in a neonatal population[J]. Pediatr Radiol, 2018, 48(1):109-119.
[89]
Schuster M, Nave H, Piepenbrock S, et al. The carina as a landmark in central venous catheter placement[J]. Br J Anaesth, 2000, 85(2):192-194.
[90]
Taylor JE, Tan K, Lai NM, et al. Antibiotic lock for the prevention of catheter-related infection in neonates[J]. Cochrane Database Syst Rev, 2015(6):CD010336.
Ullman AJ, Cooke ML, Mitchell M, et al. Dressings and securement devices for central venous catheters (CVC)[J]. Cochrane Database Syst Rev, 2015(9):CD010367.
[95]
Craven DL, BNut&Diet. Evidence Summary. Peripherally inserted central catheters (neonates):dressing of insertion site[Z]. The Joanna Briggs Institute EBP Database, JBI@Ovid, 2018:JBI19643.
[96]
Garland JS, Alex CP, Mueller CD, et al. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates[J]. Pediatrics, 2001, 107(6):1431-1436.
[97]
Milstone AM, Reich NG, Advani S, et al. Catheter dwell time and CLABSIs in neonates with PICCs:a multicenter cohort study[J]. Pediatrics, 2013, 132(6):e1609-e1615.
Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease:antithrombotic therapy and prevention of thrombosis, 9th ed:American College of Chest Physicians evidence-based clinical practice guidelines[J]. Chest, 2012, 141(2 Suppl):e419S-e496S.
[100]
Lyman GH, Bohlke K, Khorana AA, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer:American Society of Clinical Oncology clinical practice guideline update 2014[J]. J Clin Oncol, 2015, 33(6):654-656.
[101]
Jones MA, Lee DY, Segall JA, et al. Characterizing resolution of catheter-associated upper extremity deep venous thrombosis[J]. J Vasc Surg, 2010, 51(1):108-113.
[102]
Gnannt R, Waespe N, Temple M, et al. Increased risk of symptomatic upper-extremity venous thrombosis with multiple peripherally inserted central catheter insertions in pediatric patients[J]. Pediatr Radiol, 2018, 48(7):1013-1020.
[103]
Kucher N. Clinical practice. Deep-vein thrombosis of the upper extremities[J]. N Engl J Med, 2011, 364(9):861-869.
[104]
Shah PS, Shah VS. Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters[J]. Cochrane Database Syst Rev, 2008(2):CD002772.
[105]
Bin-Nun A, Wasserteil N, Nakhash R, et al. Heparinization of long indwelling lines in neonates:systematic review and practical recommendations[J]. Isr Med Assoc J, 2016, 18(11):692-696.
Uslu S, Ozdemir H, Comert S, et al. The effect of low-dose heparin on maintaining peripherally inserted percutaneous central venous catheters in neonates[J]. J Perinatol, 2010, 30(12):794-799.
[108]
Shah PS, Kalyn A, Satodia P, et al. A randomized, controlled trial of heparin versus placebo infusion to prolong the usability of peripherally placed percutaneous central venous catheters (PCVCs) in neonates:the HIP (Heparin Infusion for PCVC) study[J]. Pediatrics, 2007, 119(1):e284-e291.
[109]
Birch P, Ogden S, Hewson M. A randomised, controlled trial of heparin in total parenteral nutrition to prevent sepsis associated with neonatal long lines:the Heparin in Long Line Total Parenteral Nutrition (HILLTOP) trial[J]. Arch Dis Child Fetal Neonatal Ed, 2010, 95(4):F252-F257.
[110]
Kamala F, Boo NY, Cheah FC, et al. Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates[J]. Acta Paediatr, 2002, 91(12):1350-1356.
Barekatain B, Armanian AM, Salamaty L, et al. Evaluating the effect of high dose versus low dose heparin in peripherally inserted central catheter in very low birth weight infants[J]. Iran J Pediatr, 2018, 28(3):e60800.
[113]
Ista E, van der Hoven B, Kornelisse RF, et al. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages:a systematic review and meta-analysis[J]. Lancet Infect Dis, 2016, 16(6):724-734.
[114]
Payne V, Hall M, Prieto J, et al. Care bundles to reduce central line-associated bloodstream infections in the neonatal unit:a systematic review and meta-analysis[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(5):F422-F429.
[115]
Romantsik O, Bruschettini M, Zappettini S, et al. Heparin for the treatment of thrombosis in neonates[J]. Cochrane Database Syst Rev, 2016(11):CD012185.
[116]
Chow LM, Friedman JN, Macarthur C, et al. Peripherally inserted central catheter (PICC) fracture and embolization in the pediatric population[J]. J Pediatr, 2003, 142(2):141-144.
[117]
Miall LS, Das A, Brownlee KG, et al. Peripherally inserted central catheters in children with cystic fibrosis. Eight cases of difficult removal[J]. J Infus Nurs, 2001, 24(5):297-300.
[118]
Sharpe EL, Roig JC. A novel technique for difficult removal of a neonatal peripherally inserted central catheter (PICC)[J]. J Perinatol, 2012, 32(1):70-71.