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Mechanical complications of weekly care and maintenance versus once every 10 days of the peripherally inserted central catheter line insertion site in newborns: A propensity score-matched cohort study in Mexico

Published:September 12, 2022DOI:https://doi.org/10.1016/j.pedn.2022.08.022

      Highlights

      • The care and maintenance of a PICC line insertion site over a 10-day period in newborns are introduced.
      • Care and maintenance every 7 days were found to have increased risk for PICC line breakage.
      • Weekly care and maintenance carry more risk of mechanical complications compared to care and maintenance every 10 days.

      Abstract

      Purpose

      To evaluate the mechanical complications of weekly care and maintenance versus once every 10 days of the peripherally inserted central catheter (PICC) line insertion site versus once every 10 days in newborns.

      Design and methods

      Prospective propensity score matched cohort study. Care and maintenance of the PICC line insertion site were performed on days 7 and 10 during January 2018 to December 2019. To compare mechanical complications, propensity score matching was performed. Propensity scores were used to determine the relative risks and hazard ratios by using logistic regressions with log-link function and Cox regressions, respectively.

      Results

      We included 175 newborns hospitalized in the neonatal intensive care unit (NICU) who underwent insertion of a PICC line. Ninety-six received weekly care and maintenance, and 79 received care and maintenance every 10 days. Weekly care and maintenance were associated with more breakage (RR 1.98, 95% CI 1.68–2.34); occlusions (RR 0.81, 95% CI 0.46–1.42) and accidental withdrawals (RR 1.31, 95% CI 0.93–1.84) were not different between care and maintenance every 7 and 10 days. A survival analysis was performed, showing that weekly care and maintenance are a risk factor for removal for mechanical complications (HR 7.61, 95% CI 3.05–19.01).

      Conclusion

      We concluded that care and maintenance of the PICC in newborns every 10 days have fewer complications than when performing care and maintenance every 7 days.

      Practice implications

      Newborns requiring intravenous therapy will benefit from care and maintenance every 10 days, and this practice could potentially spread to other NICUs.

      Keywords

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