Percutaneously inserted central catheter - infants

A PICC is a long, very thin, soft plastic tube made of silicone or polyurethane that is placed in a small blood vessel to allow IV fluids and medications to be given.

WHY IS A PICC USED?

The primary reason for a PICC is to allow for IV nutrition to be given over a long period of time without having to frequently replace an IV. The normal short IV usually last only 1-3 days before needing to be replaced. A PICC can often be maintained for 2-3 weeks, or longer. Infants most likely to benefit from a PICC include very immature infants, infants with bowel problems preventing feeding, and infants who require a very long course of IV medication.

HOW IS A PICC PLACED?

Sterile techniques similar to an operation are used to clean the skin. Pain medication may be used to minimize discomfort. A tiny needle is inserted into a small vein, usually in the arm or leg. The PICC line is advanced through the needle so the tip is in a big vein near (but not in) the heart. The position of the PICC is determined by an x-ray. Sometimes a special solution is used to make it easier to see the PICC on the x-ray.

WHAT ARE THE RISKS OF A PICC?

Sometimes, despite several attempts, a PICC just cannot be properly positioned. As with any form of IV the use of a PICC carries a small risk of infection (at the skin or in the blood). The longer the PICC is in the greater the risk for infection. Though the catheters are very soft and flexible, at times they can erode through the blood vessel wall causing the IV fluid or medication to leak into the tissue or body cavity.

In very rare instances, erosion through a wall of the heart can occur and cause serious bleeding and poor heart function. Another very rare complication is breaking of the catheter in the blood vessel.

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