Wen Jie, Yu Qun, Chen Haiyan, Chen Niannian, Huang Shourong, Cai Wei
Department of Pediatric Surgery, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Asia Pac J Clin Nutr. 2017 Jan;26(1):1-5. doi: 10.6133/apjcn.112015.07.
The placement of a peripherally inserted central venous catheter (PICC) is an essential procedure in neonatal intensive care units (NICU). The aim of this study was to determine the risk of PICC complications in NICU, and further identify the effects of PICC complications on body weight gain in premature infants.
A total of 304 premature infants who had a PICC inserted in NICU were enrolled in this study. The weight-for-age z-score (WAZ) at the time of PICC insertion and removal were calculated, and changes of WAZ in different groups were compared using a t-test. Risk factors for PICC complications were assessed using the chi-squared test and multiple logistic regression analysis.
Thirty (9.97%) PICCs were removed due to complications. Of them, 14 PICCs were removed because of non-infectious complications and 16 PICCs were removed for central-line-associated bloodstream infections (CLABSIs). Multiple logistic regression analysis showed that premature infants with birth weight >1,500 g were less likely to have PICC complications than infants with birth weight <=1,500 g (OR, 0.29; 95% CI: 0.10-0.82; p=0.020). In addition, the changes in WAZ between PICC insertion and removal were significantly different in both infectious (-0.144±0.122, p<0.005) and non-infectious (-0.65±0.528, p<0.001) complications groups, compared with the no complications group (0.291±0.552).
Findings from this study suggest that birth weight is a risk factor for PICC-associated complications in the NICU, and both infectious and non-infectious PICC complications are associated with poor body weight gain in premature infants.
外周静脉穿刺中心静脉置管（PICC）是新生儿重症监护病房（NICU）的一项重要操作。本研究旨在确定NICU中PICC并发症的风险，并进一步明确PICC并发症对早产儿体重增加的影响。
本研究纳入了304例在NICU接受PICC置管的早产儿。计算PICC置管时和拔除时的年龄别体重Z评分（WAZ），并使用t检验比较不同组WAZ的变化。采用卡方检验和多因素逻辑回归分析评估PICC并发症的危险因素。
30例（9.97%）PICC因并发症被拔除。其中，14例PICC因非感染性并发症被拔除，16例PICC因中心静脉导管相关血流感染（CLABSI）被拔除。多因素逻辑回归分析显示，出生体重>1500g的早产儿发生PICC并发症的可能性低于出生体重≤1500g的婴儿（OR，0.29；95%CI：0.10-0.82；p=0.020）。此外，与无并发症组（0.291±0.552）相比，感染性（-0.144±0.122，p<0.005）和非感染性（-0.65±0.528，p<0.001）并发症组在PICC置管和拔除之间的WAZ变化均有显著差异。
本研究结果表明，出生体重是NICU中PICC相关并发症的一个危险因素，感染性和非感染性PICC并发症均与早产儿体重增加不良有关。
