Percutaneously inserted central catheter

Percutaneously inserted central catheter - infants

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

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A percutaneously inserted central catheter (PICC) is a long, very thin, soft flexible 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 (intravenous) fluids or medicines over a long period of time, or the nutrition or medication is not safe to give through a smaller vein. 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 be fed 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).
Insert a 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 confirm the PICC is in the correct position.
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 irregular heartbeat, serious bleeding, and poor heart function.
Very rarely, the catheter may break inside the blood vessel.

References

Center of Disease Control and Prevention website. Intravascular catheter-related infection (BSI) prevention guidelines. www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infection/?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/guidelines/BSI/index.html. Updated April 12, 2024. Accessed June 19, 2024.

Edwards LR, Malone MP, Prodhan P, Schexnayder SM. Pediatric vascular access and centeses. In: Zimmerman JJ, Clark RSB, Fuhrman BP, et al, eds. Fuhrman and Zimmerman's Pediatric Critical Care. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 14.

Huff KA, Denne SC. Parenteral nutrition for the high-risk neonate. In: Gleason CA, Sawyer T, eds. Avery's Diseases of the Newborn. 11th ed. Philadelphia, PA: Elsevier; 2024:chap 60.

Review Date: 12/31/2023

Reviewed By: Mary J. Terrell, MD, IBCLC, Neonatologist, Cape Fear Valley Medical Center, Fayetteville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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