Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7944-7953
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7944
Peripherally inserted central catheter placement in neonates with persistent left superior vena cava: Report of eight cases
Qiong Chen, Yan-Ling Hu, Ying-Xin Li, Xi Huang
Qiong Chen, Yan-Ling Hu, Ying-Xin Li, Xi Huang, Department of Neonatal Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
Qiong Chen, Yan-Ling Hu, Ying-Xin Li, Xi Huang, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
Author contributions: Chen Q contributed to the study design and data analysis and drafted the manuscript; Huang X contributed to the data analysis and critically revised the manuscript; Hu YL and Li YX critically revised the manuscript; all authors have read and approved the final manuscript.
Supported by the 2017 Scientific Research Project of Sichuan Health and Family Planning Commission, No. 18PJ215.
Informed consent statement: The parents of the patients described herein were informed about the treatment-related risks and benefits. In addition, informed written consent was obtained from the patients’ parents for publication of this report and any accompanying images. This study was reviewed and approved by the hospital ethics committee [2020 Medical Scientific Research for Ethics Approval No. (115)], and written informed consent was provided by the patients’ parents/guardians before their participation in this study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xi Huang, MSN, Nurse, Department of Neonatal Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 20 Section 3, Renmin South Road, Chengdu 610041, Sichuan Province, China. 422106638@qq.com
Received: May 12, 2021
Peer-review started: May 12, 2021
First decision: June 15, 2021
Revised: July 1, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: September 16, 2021
Abstract
BACKGROUND

Reports on peripherally inserted central catheter (PICC) placement in neonates with persistent left superior vena cava (PLSVC) are rare. The majority of PLSVC patients have no clinical symptoms or hemodynamic changes, which are usually detected during cardiac catheterization, cardiac pacemaker implantation, or PICC placement. However, in neonates with PLSVC, PICC placement can be challenging. Here, we report PICC placement in eight neonates with PLSVC.

CASE SUMMARY

This article introduces the concept of the “TIMB” bundle. After PICC implantation, we found PLSVC in all eight patients. The key points of care regarding PICC placement in neonates with PLSVC included “TIMB”, where “T” indicates a reasonable choice of the catheterization time, “I” refers to a retrospective analysis of imaging data before catheterization, “M” refers to correct measurement of the body surface length, and “B” indicates that the tip of the PICC is placed in the middle and lower 1/3 of the left superior vena cava under the guidance of B-ultrasound.

CONCLUSION

“TIMB” is a bundle for PICC placement in neonates, especially for those with PLSVC. Using this new approach can improve the first-attempt success rate of PICC placement, reveal cardiovascular abnormalities in advance, allow the selection of different measurement methods reasonably according to the puncture site, and finally, improve the accuracy of catheter positioning through the use of B-ultrasound guidance.

Keywords: Neonate, Persistent left superior vena cava, Peripherally inserted central catheter, Complications, “TIMB” bundle, Case report

Core Tip: We report rare cases of persistent left superior vena cava in neonates in whom peripherally inserted central catheter placement was difficult. We faced unprecedented difficulties and challenges during the process of catheterization; several conventional methods were used. Finally, we successfully established a new approach of tube placement, that is, “TIMB”, where “T” indicates time, “I” refers to imaging data, “M” refers to measurement, and “B” indicates B-ultrasound.