Effect of heparin and other factors associated with complications of peripherally inserted central venous catheters in neonates

Abstract

To identify factors associated with complications necessitating unplanned removal of peripherally inserted central venous catheters (PICCs) in neonates. A before-and-after comparison following the exclusion of heparin from continuous infusions through PICCs placed by a designated team. Duration of use was assessed during epochs immediately preceding and following the practice change. Multivariable logistic regression was performed to identify independent risk factors associated with unplanned catheter removal. We analyzed 189 PICC placements with heparin (epoch 1) and 188 with no heparin (epoch 2) added to infusions. Rates of complication (23.7 vs 17.2 per 1000 catheter days) and median durations of use (7 vs 8 days) did not differ significantly between the epochs. Non-central position of the catheter tip, use of dual lumen catheters and placement through the cephalic vein were independently associated with complications (each P<0.05). In neonates requiring short-term intravenous access, heparin may be safely omitted from continuous infusions without compromising catheter usability.