707 - Risk Factors for Neonatal PICC Complications: The Role of Insertion Timing and Site

Publication Number: 1684.707

RONELLA MAROM, Tel aviv Medical Center, Tel Aviv, Tel Aviv, Israel; Chen Nozik, Tel aviv Medical Center, Tel Aviv, Tel Aviv, Israel; Laurence Mangel, Tel Aviv Medical Center, Tel Aviv, HaMerkaz, Israel; Dror Mandel, Dana Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Tel Aviv, Israel; Rafael Mendelsohn, Tel Aviv Medical Center, tel aviv, Tel Aviv, Israel; Sharon Morag, Tel Aviv Medical center, Tel Aviv, HaMerkaz, Israel; Kevin Benita, Tlvmc, Tel Aviv, Tel Aviv, Israel

Background: Peripherally inserted central catheters (PICCs) are indispensable in neonatal intensive care but can cause significant complications.

Objective: To examine whether PICC insertion timing and anatomical site are associated with complications after accounting for infant characteristics, and to compare risk profiles across extremely low birth weight (ELBW), very low birth weight (VLBW), and ≥1500 g neonates.

Design/Methods: We conducted a retrospective cohort study of all neonates with ≥1 PICC in a tertiary NICU. Outcomes included central line–associated bloodstream infections (CLABSI) and mechanical events; multivariable models were constructed separately for ELBW, VLBW, and ≥1500 g infants.

Results: Among 874 neonates, complication risk increased with decreasing birth weight: ELBW 19.4%, VLBW 9.0%, and ≥1500 g 2.4%, predominantly CLABSI.
In ELBW infants, each additional gestational week and 100 g of birth weight reduced the odds of complications by ~34% and ~33%, respectively. In VLBW infants, higher birth weight was protective. Insertion timing and right vs left upper-limb site were not independent predictors. In ≥1500 g neonates, PICC complications were associated with NEC and delayed full feeds.

Conclusion(s): Host factors (Gestational age/Birth weight) and downstream clinical course dominate risk; insertion side did not independently affect complications. Prevention should prioritize maintenance bundles, minimizing dwell time, and individualized device planning.

Table1-Neonatal characteristics by birth weight (BW)
Table 1 - Neonatal characteristics by birth weight (BW) (1).pdf

Table 2- Comparison between neonates below 1500g with or without PICC-1 complications
Table 2 Comparison between neonates below 1500g with or without PICC-1 complications.pdf

Table 3- Comparison between extremely low birth weight infants 1000g with or without PICC-1 complication
Table 3- Comparison between extremely low birth weight infants 1000g with or without PICC-1 complication.pdf