Short presentation on percutaneously inserted central catheter PICC in premature babies (preemies) and neonates.

1. Khaled Bahaaeldin
Professor of Pediatric surgery
KasrAlAiny school of medicine,
Cairo University
3/17/2014

2. 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
K.H. Bahaaeldin3/17/2014 2

3. Peripheral Vs Central
Peripheral Central
 Basic skill level
 Initially more available
 Short life span
 Low mixing blood volume
 Low potential for grave
complications
 Sepsis is function of number
& time
 Skilled procedure
 Limited routes
 Potentially indefinite use
 High mixing blood volume
 Relatively graver/life risking
complications
 Sepsis is function of time
K.H. Bahaaeldin3/17/2014 3

4. PICC line
It possibly offers the best
of both worlds.
However there is always
a price to pay for any
compromise!
 Basic skill level
Peripheral Vein cannulation.
 Central placement
At the Junction of either the Superior or
Inferior Venae Cava with the right atrium.
 Potentially indefinite placement
 Lower 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!
K.H. Bahaaeldin3/17/2014 4

5. I had four wise friends
They taught me all I knew
Their names were:
when, how, where and who
K.H. Bahaaeldin3/17/2014 5

6. PICC line
 Who; any preemie or neonate
requiring admission >7 days
 Where; 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
K.H. Bahaaeldin3/17/2014 6

7. K.H. Bahaaeldin3/17/2014 7

8. K.H. Bahaaeldin3/17/2014 8

9. K.H. Bahaaeldin3/17/2014 9

10. Thank you for your time
K.H. Bahaaeldin3/17/2014 10