Análise de medida do cateter central de inserção periférica para instalação em neonatos: estudo de coorte

Introduction: The Peripherally Inserted Central Catheter is a device widely used in intensive care units due to its low cost, insertion at the bedside, less risk of complications. Although this device has been implanted very frequently in the Intensive Care Units, there is still a large number of unfavorable events related to the catheter and the duration of this catheter in the neonatal clientele is below that indicated for use. The General objective was to analyze the measurement of the peripherally inserted central catheter installed in newborns admitted to a neonatal intensive care unit. Method: This is an observational, prospective cohort study with 24 newborns admitted to two reference institutions in Rio de Janeiro from July 2019 to January 2020, using a data collection instrument. Data analysis was performed using statistical calculations. This study was approved by the ethics committee with registration number 12126219.8.3001.5279. Results: The participating neonates were mostly male (62.5%), born weighing between 570g and 1,196g (54.2%), aged between 1 and 7 days (66.7%), and were under treatment due to prematurity (70.8%). The catheters used were mostly made of silicone (54.2%); inserted in the right upper limb (62.5%), in the Basilica (37.5%) or in the Cubital Median (29.2%); with the tip of the catheter in the third Intercostal space (58.3%). It is estimated, therefore, that traction occurred in (75.0%) of the inserted catheters and the frequency distribution of the traction length, in centimeters, was between 1 cm (33.3%) or 2 cm (25.0%) , and that the non-use of sedatives are related to the occurrence. In 91.7% of cases, the conventional measurement is greater than the proposed measurement, reaching 5 cm greater. Discussion: When compared to the conventional measure and the measure proposed by the study, it appears that in (91.7%) of the cases, the conventional measure is greater than the proposed measure. A few centimeters previously established before insertion with the conventional measurement proved to be doubtful, considering the occurrence of traction in (75.0%) of the PICC. Still, the less successful the correct position of the device, the greater the risks to the newborn, in addition to excessive manipulation for traction maneuvers. Conclusion: Among the findings in the sample studied, research suggests that catheters should always be inserted with analgesics, that professionals are trained to make the insertion in less time and that they change the conventional measure by the proposed measure since the conventional measure is greater than the proposed measure in 91.7% of cases and the larger conventional measure is significantly associated with traction . It is suggested, then, that the proposed measurement measure of the PICC for its installation in neonates in this study be investigated in new studies in order to emerge more robust scientific evidence.