Complication rates with central venous catheters inserted at femoral and non-femoral sites in very low birth weight infants

OBJECTIVE:: To compare the complication rates of femoral versus nonfemoral sites of percutaneously inserted central venous catheters (PICCs) in very low birth weight infants. METHODS:: Between 2004 and 2006, 518 PICCs inserted in 334 neonates with a birth body weight 1500 g were studied. 278 catheters were inserted at nonfemoral sites, and 240 catheters at a femoral site. All catheter-related complications were recorded and analyzed. RESULTS:: The infants with femoral PICCs had a significantly higher rate of catheter-related sepsis (CRS) than those with nonfemoral PICCs (22.5% vs. 12.2%, P = 0.002) and the incidence rate was also significantly higher (10.9 vs. 6.8 episodes per 1000 catheter days, P = 0.012). The infants with nonfemoral PICCs had significantly higher rates of phlebitis, catheter site inflammation, and need for early removal than those with femoral PICCs. Multiple logistic regression analysis showed that the significant contributors to CRS were duration of the PICC placement (P < 0.001) and insertion of the PICC at a femoral site (P = 0.010). CONCLUSIONS:: Because of a higher rate of CRS, the femoral site should not be considered for the placement of PICCs in VLBW infants, when possible.