RESUMO
BACKGROUND: There have been few reports on level 3 difficult removal of peripherally inserted central catheter (PICC) in neonates. Here, we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC. CASE SUMMARY: Female baby A, weighing 1070 g at 27+1 wk of gestational age, was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome. She underwent PICC insertion twice. The first PICC insertion went well; the second PICC was inserted in the right lower extremity, however, phlebitis occurred on the second day after the placement. On the third day of catheterization, phlebitis was aggravated, while the right leg circumference increased by 2.5 cm. On the fourth day of catheterization, more red swelling was found in the popliteal part, covering an area of about 1.5 cm × 4 cm, which was diagnosed as phlebitis level 3; thus, we decided to remove the PICC. During tube removal, the catheter rebounded and could not be pulled out (several conventional methods were performed). Finally, we successfully removed the PICC using a new approach termed "AFGP". On the 36th day of admission, the baby fully recovered and was discharged. CONCLUSION: The "AFGP" bundle approach was effective for an extremely preterm infant, who underwent level 3 difficult removal of a PICC.
RESUMO
OBJECTIVE: To study the effect of golden-hour body temperature bundle management strategy on admission temperature and clinical outcome in preterm infants with a gestational age of <34 weeks after birth. METHODS: The preterm infants who were born in the delivery room of the West China Second University Hospital of Sichuan University and admitted to the department of neonatology of this hospital within 1 hour after birth from December 2015 to June 2016 and from January to May, 2017 were enrolled. The 173 preterm infants who were admitted from January to May, 2017 were enrolled as the intervention group and were given golden-hour body temperature bundle management. The 164 preterm infants who were admitted from December 2015 to June 2016 were enrolled as the control group and were given conventional body temperature management. RESULTS: The intervention group had a significantly higher mean admission temperature than the control group (36.4±0.4°C vs 35.3±0.6°C; P<0.001). The incidence rate of hypothermia on admission in the intervention group was significantly lower than that in the control group (56.6% vs 97.6%; P<0.001). The intervention group had a significantly lower incidence rate of intracranial hemorrhage within one week after admission than the control group (15.0% vs 31.7%; P<0.05). CONCLUSIONS: Golden-hour body temperature bundle management for preterm infants within one hour after birth can reduce the incidence of hypothermia on admission and improve clinical outcome.
