Percutaneously inserted central catheter - infants

Alternative Names

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

Information

A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic 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 fluids or medicine 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 feed 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

Pasala S, Storm EA, Stroud MH, et al. Pediatric vascular access and centeses. In: Fuhrman BP, Zimmerman JJ, eds. Pediatric Critical Care. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 19.

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 October 24, 2019.