Maneuver for advancing and positioning of peripherally inserted central catheters in newborns

The objective of this study was to evaluate the maneuver for advancing a peripherally inserted central catheter (PICC) in newborns with and without the use of the three steps of elevation, protraction and lowering (EPL) of the shoulder. This is a cross-sectional, quantitative study with a sample of 113 PICC insertions in the basilic or cephalic veins of newborns admitted to a neonatal unit. The majority of catheters that required the use of the maneuver were advanced after the first step; a greater proportion of centrally positioned catheters were inserted through the right basilic vein (86.2%); and chronological age and catheterized vein were significantly different (p < 0.05). It was concluded that the first and second steps of the EPL maneuver were effective in advancing the PICC in the right midclavicular region through catheterization of the right basilic vein.