Relação entre o sítio de implantação do Cateter Venoso Central de Inserção Periférica e as causas da sua remoção

Abstract

Technological advances made in science have helped to maintain the life of newborns (RN's), requiring greater demand for skilled professionals to offer a qualified assistance. In certain clinical situations, the use of catheters Central Venous in neonates is inevitable. Due to ease of punching, prolonged length of stay and reduced the risk of complications of the Peripherally Inserted Central Catheter (PICC) it has been used extensively, allowing this population of fragile skin and small veins a secure and stable venous access. Although the numerous benefits, the literature points to a number of complications, often resulting in early catheter removal. Thus, this research aims to describe the incidence of removal PICC and analyze the relationship between the insertion site and the appearance of complications. This is a quantitative, descriptive study, with retrospective approach. Was carried out a data collection by the medical records and customer tracking form with PICC. Newborns admitted to the Intermediate Care Unit - Nursery Unit and Neonatal Intensive Care and Pediatric Clinical Hospital of the Federal University of Minas Gerais Triangle of Uberaba-Minas Gerais participated in the search, receiving intravenous therapy through the PICC. Statistical analysis was performed using measures of central tendency (median and average), simple frequency tables and contingency tables. They underwent PICC insertion procedure during the period January 1st, 2013 to December 31st, 2014, 378 RN's, totaling 616 implantations. There was a predominance of males, declared white, in its majority coming from Uberaba, low birth weight, without the need for resuscitation in the delivery room, the main diagnoses to Respiratory Distress Syndrome of Newborn admission. Regarding the insertion of the PICC, 56.6% of the RN's were catheterized once, but obtaining a prevalence of 63.0% complications, and 57.3% inserts were held in the upper limbs, in which the most commonly used vein was left median cubital vein (10.7%). The PICC's inserted in the upper limbs, 54.5% had complications, the most frequent obstruction (20.4%). PICC's inserted in the lower members, 70.0% had complications, obstruction (22.6%) and infection (18.7%) the most frequent. About the PICC's inserted into the cerebro-cervical region, 54.3% had complications, obstruction (17.5%) and accidental traction (13.0%) the most frequent. Because of the emergence of these complications, the procedure is the removal of the catheter. Intravenous therapy presents essential character in survival of this population, it is essential to its achievement, becoming increasingly present in neonatal care services. Thus, the training of nurses who work in this area is essential, basing the correct handling of PICC and preventing the emergence of complications. Therefore it highlights the importance of the development and standardization of care delivered through the implementation of a clinical protocol that aims at the integration, maintenance and removal of the catheter as well as the orientation and continuing education of professionals.