Percutaneously Inserted Central Cather Line (preemies and neonates)

Khaled BahaaeldinProfessor of Pediatric surgery

KasrAlAiny school of medicine,Cairo University

3/17/2014

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When resources become skimpy, human beings don't suddenly cooperate to conserve what's left. They fight to the last scrap for possession of a diminishing resource.

Deepak Chopra

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Peripheral Vs CentralPeripheral Central

Basic skill levelInitially more availableShort life spanLow mixing blood

volumeLow potential for grave

complicationsSepsis is function of

number & time

Skilled procedureLimited routesPotentially indefinite useHigh mixing blood

volumeRelatively graver/life

risking complicationsSepsis is function of time

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PICC line

It possibly offers the best of both worlds.However there is always a price to pay for any compromise!

Basic skill levelPeripheral Vein cannulation.

Central placementAt the Junction of either the Superior or Inferior Venae Cava with the right atrium.

Potentially indefinite placementLower Risk and Gravity of

complications. Remember it’s still a central venous access!

Cost!Restriction on infusate (only for

small Preemie caliber 1Fr)More care demanding than both!

Place it before it’s too late!

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I had four wise friendsThey taught me all I knew

Their names were: when, how, where and who

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PICC line Who; any preemie or neonate

requiring admission >7 daysWhere; theoretically any

peripheral vein will end up in superior or inferior vena cava

How; Asepsis, cannulation skill, gently, patiently and confirm tip placement.

When; Make the decision early! Available peripheral veins. Every puncture = potential sepsis Spare peripheral veins

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Thank you for your time