Detection of peripherally inserted central catheter occlusion by in-line pressure monitoring.

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Peripherally inserted central catheters (PICC) are being increasingly used in neonatal practice. Their use is not without technical difficulty. This report describes the use of continuous pressure monitoring to detect catheter occlusion in critically ill neonates. In-line venous pressure of the PICC line was monitored by pressure transducer in neonates; 28-gauge 20 cm PICC or 29-gauge 25 cm PICC were used. In-line pressure of the PICC was monitored 64 times in 50 neonates. Increases in the in-line pressure were observed when the catheter tip was against the vessel wall and the catheter was obstructed partially or completely. Decreases were observed when the infusion syringe was changed and when an inappropriate infusion rate was set. Two infants experienced marked variations of blood pressure due to intermittent catheter occlusion of the tip against the vessel wall. These infants were receiving dopamine via a PICC line. In critically ill infants, in-line pressure monitoring of the PICC is helpful in detecting the occlusion of the catheter.