Effects of neonatal peripherally inserted central venous catheter failure in the neonatal intensive care unit and the associated clinical implications.

Background: We retrospectively analyzed how peripherally inserted central venous catheter (PICC) failure and the associated complications affected patient outcomes.

Methods: Neonatal intensive care unit (NICU) neonates who had PICCs inserted at our institution from January 2019 to December 2022 were enrolled in this study. The 238 patients were divided into two groups: Group 1 (n = 186; PICC removed due to treatment completion) and Group 2 (n = 52; PICC removed due to failure). The primary outcome was the duration of hospital stay, and the secondary outcome was mechanical ventilation durations and the duration of PICC stay (the total number of days of PICC including the second and subsequent times). A time-dependent Cox regression analysis and multivariate regression analysis were performed.

Results: PICC failure was independently associated with an increased risk of a hospital stay exceeding 42 days (odds ratio 8.50; 95% confidence interval, 2.68-31.6) after adjusting for gestational age, birth weight, gastrointestinal disease, and mechanical ventilation. However, the PICC failure with mechanical ventilation had limited impact on the outcome.

Conclusions: PICC failure was associated with a prolonged hospital stay and total duration of PICC stay. The risk factors for prolonged hospital stays in this study were prematurity, gastrointestinal disease, mechanical ventilation, and PICC failure.