Topics Discussed: catheterization, central venous; central venous catheter; hematology; venous access.
Excerpt:"Indications. Percutaneous central venous catheterization (peripherally inserted central catheter, or PICC) involves inserting a long small-gauge catheter into a peripheral vein and threading it into a central venous location. The catheter is placed peripherally but is longer than the usual intravenous (IV) device, and hence its tip lies in a more central location. The catheter can be placed in large vessels such as the cephalic and basilic veins in the arm or the saphenous vein in the leg.
- When it is anticipated that an infant will need IV access for several weeks.
- In low birthweight infants when it is anticipated that full enteral feedings will not be achieved within a short period.
- For the delivery of fluids, nutritional solutions, and medications when other venous access is not acceptable (eg, hypertonic IV solutions).
Equipment. Cap and mask, sterile gloves, a sterile gown, and a neonatal percutaneous catheter device are needed. Two types of devices are available: Silastic catheters, which generally do not have an introducer wire, and polyurethane catheters, which contain an introducer wire. Several sizes are available, ranging from 24 gauge to as small as 28 gauge in diameter, which is useful in infants <1000 g. Double-lumen catheters are also..."
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