• Priscila Costa, Mariana Bueno, Angelina Maria Aparecida Alves, and Amélia Fumiko Kimura.
• Department of Maternal-Child and Psychiatric Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil. priscila2.costa@usp.br
• J Obstet Gynecol Neonatal Nurs. 2013 May 1; 42 (3): 348-56.

ObjectiveTo compare the incidence and reasons for nonelective removal of percutaneously inserted central catheters (PICC lines) between centrally and noncentrally placed PICC lines in neonates.DesignProspective cohort study.SettingA 60-bed, tertiary-level neonatal intensive care unit in a private hospital in São Paulo, Brazil.ParticipantsNeonates who were born at the hospital and underwent successful insertion of 237 PICC lines. They were divided into two groups, central and noncentral, according to tip position.MethodsNeonates were monitored daily from insertion of the PICC until its removal. Data were collected from medical records.ResultsOf the 237 PICCs analyzed, 207 (87.4%) had their tip in a central position and 30 (12.6%) in a noncentral position. The incidence of nonelective PICC removal was similar between the central and noncentral groups (p = .48). The reasons for nonelective removal were significantly different between the groups (p = .007), with a higher incidence of extravasation in the noncentral group.ConclusionNoncentrally placed PICCs can provide vascular access in neonates requiring venous access for the administration of intravenous solutions. Many potential catheter-related complications can be prevented by careful bedside nursing. Frequent monitoring of noncentral PICCs is necessary to detect and prevent extravasation in neonates.© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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