Alternative Names

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

Information

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.