OBJECTIVE: Analysis of the use of peripherally inserted central catheter(PICC) after the first year of its implementation in a NICU and of the global incidence and density of complications, as well as distribution of birth weigth and duration of this device according to weight range.

MATERIAL AND METHODS: The design of the study was a crosscut. The analysis was carried out at “Centro de Prematuros do Estado do Rio de Janeiro” (CEPERJ), with an average daily census of 11 newborns (NB), from July 1st, 1996 till June 30th, 1997. The placement of PICCs(Epicutaneo®, by Vygon) was performed by Registered Nurses, using especific material for the procedure and respecting all aseptic techniques. The following complications were accounted for: systemic infection related to catheter (accordind to NNIS criteria), catheter local infection, non-infectious complications like edema, obstrution, infiltration and discontinuation. All data were analysed through Epinfo 6.0% software. For statistical comparisons it was used χ2 test with the significance level< 0,05.

RESULTS: During the period of the study, 374 NB were admitted to the NICU. The device was used in 76 of them. For a total of 106 PICCs inserted, there were 16 venous dissections, 57 umbilical catheterizations, representing a total of 1,210 patients/day with catheters. Distribuition according to birth weight showed that 78.3% of the PICCS were inserted in NB < 2,500 g (IC 95%= 69.2 - 85.7%). Median dwell time was 7 days, and the maximum median observed in NB < 1,000 g was 18.5 days. The main reason for device removal was discontinuation of intravenous fluid infusion which occured in 40.6% (IC 95% = 31.1 - 50.5%). Infection related to PICCs occured in 16.9% (IC 95% = 10.3 - 25.5%). The non-infectious complications occured in 34% (IC 95% = 25.0 - 43.8%), being infiltration the main cause and seen in 18.8% (IC 95% = 11.9 - 27.6%).

CONCLUSION: With the utilization of PICCs there was a redutions on deep venous dissections, from 8% in the previous year to 4%. The high incidence of infectious complications (basically catheter related sistemic infection) may be explained by the standardization used by NNIS criteria. Due to its long-term and proved efficacy, when compared with central venous catheter, this experience supports the early used of PICC in NB < 1,500 g needing intravenous support.