Insertion of peripherally inserted central catheters in neonates less than 1.5kg using ultrasound guidance.

Abstract

Neonates commonly require central access, and in those with very low or extremely low birthweight this can be challenging. Described here is a technique that uses ultrasound guidance in the placement of peripherally inserted central catheters (PICC) in neonates and an analysis of outcomes. A retrospective chart review was conducted of all patients below 1500g that underwent placement of a peripherally inserted central catheter under ultrasound guidance between January 1, 2012, and December 31, 2014 at a single center. All patients had multiple previous attempts at PICC placement by experienced NICU vascular access nurses prior to referral. Complications were determined based on clinical and procedural notes. A total of ten patients were found during the study period. The average estimated gestational age was 29.8weeks (range 26-38weeks).The average weight at the time of PICC insertion was 968g (range 485-1390g). All attempts at placement were successful. There were no complications directly related to PICC insertion. Ultrasound guided PICC line placements using ultrasound is an effective technique, which can be applied to very low and extremely low birth weight infants, with excellent success rates and a low risk of complications.