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Percutaneously inserted central catheter - infants

PICC - infants; PQC - infants; Pic line - infants; Per-Q cath - infants

Information

A percutaneously inserted central catheter (PICC) is a long, very thin, soft flexible tube that is put into a small blood vessel and reaches deep into a larger blood vessel. This article addresses PICCs in babies.

WHY IS A PICC USED?

A PICC is used when a baby needs IV (intravenous) fluids or medicines over a long period of time. Regular IVs only last 1 to 3 days and need to be replaced. A PICC can stay in for 2 to 3 weeks or longer.

PICCs are often used in premature babies who cannot be fed because of bowel problems or who need IV medicines for a long time.

HOW IS A PICC PLACED?

The health care provider will:

  • Give the baby pain medicine.
  • Clean the baby's skin with a germ-killing medicine (antiseptic).
  • Make a small surgical cut and place a hollow needle into a small vein in the arm or leg.
  • Move the PICC through the needle into a larger (central) vein, putting its tip near (but not in) the heart.
  • Take an x-ray to place the needle.
  • Remove the needle after the catheter is placed.

WHAT ARE THE RISKS OF HAVING A PICC PLACED?

  • The health care team may have to try more than once to place the PICC. In some cases, the PICC cannot be properly positioned and a different therapy will be needed.
  • There is a small risk for infection. The longer the PICC is in place, the greater the risk.
  • Sometimes, the catheter may wear away the blood vessel wall. IV fluid or medicine can leak into nearby areas of the body.
  • Very rarely, the PICC can wear away the wall of the heart. This can cause serious bleeding and poor heart function.
  • Very rarely, the catheter may break inside the blood vessel.

References

Edwards LR, Malone MP, Prodhan P, Schexnayder SM. Pediatric vascular access and centeses. In: Zimmerman JJ, Clark RSB, Fuhrman BP, et al, eds. Fuhrman and Zimmerman's Pediatric Critical Care. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 14.

Santillanes G, Claudius I. Pediatric vascular access and blood sampling techniques. In: Roberts J, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 19.

United States Centers for Disease Control Healthcare Infection Control Practices Advisory Committee. 2011 guidelines for the prevention of intravascular catheter-related infections. www.cdc.gov/infectioncontrol/pdf/guidelines/bsi-guidelines-H.pdf. Updated October 2017. Accessed January 20, 2021.


         

        Review Date: 11/9/2021

        Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Clinical Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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