My 7 week old daughter has endocarditis, should a picc line be inserted?

she acquired the infection in the hospital in the nicu from a cardiac catheterization. she had enterococcal sepsis. they found that the sepsis came from the endocarditis, not the reverse. She is doing fine on periphereal ivs- but requires 3 more weeks of antibiotics- gentamicin and ampocilin. should we go for the picc if it increases the risk of her having another infection?

As pointed out by another responder you have not mentioned if she is currently an inpatient at a hospital. I am going to assume that with her history that she is. That said I would recommend the PICC line only if the hospital currently uses a BIO-PATCH dressing. The risk of acquiring another nosocomial (hospital acquired) infection are a bit elevated in her situation and therefore all steps at prevention should be utilized.
A BIOPATCH dressing is a small disc that is covered with an antibiotc coating and then placed at the very end of the PICC, at the insertion point. This minimizes the risk of infection and should eleviate your fears for a short time at least. The important thing to keep in mind is that your young daughters PICC line is closer to her diaper than that of an adult and therefore there is risk of E-Coli contamination. As long as the PICC dressing is changed every 72 hours and the bio-patch is replaced the risk of infection, although still a possibility, is minimized.
You may want to discuss the placement of a Hickman implanted access port if the physicians think that she may continue to need other IV medications during the year. These ports can be left in for years and are accessed with a special needle when IV therapy is initiated and then de-accessed when the course of medication is complete. It should have dressing changes every 72 to 96 hours using sterile technique.

A benefit to a PICC line is the administration of IV antibiotics close to the site of infection versus with a peripheral IV (arms / legs / etc.). With the peripheral IV the medication has some time to disperse into the bloodstream and although the potency isn't effected the concentration is. The PICC line tip is housed in the SVC (a main vein that brings blood to the heart) and therefore the medication will be in a higher concentration at the time of administration.

The medications that the physicians are wanting to order may have a role in their suggestion for a PICC line as the smaller IV's such as butterflies that are used with small children and babies are sometimes not compatible with all medications or fluids to be infused.

Do NOT get a IMPLANTED PORT (Hickman) if the use of TPN is a possiblity for supplying nourishment (calories and necessary fats, electrolytes such as potasium, etc.) There is a high risk of yeast infection with Hickman's IF TPN is administered due to the high sugar content.
You can take blood samples from either a Hickamn or a PICC so they are equal in that regard.

The PICC is gentler on the eyes though. The hickman is circular and lays under the skin but can still be seen as a small raised quarter-sized area.
Hope this helps in your decision making.
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Glad I could help. I'll keep your family in my prayers. Report It

I hope your daughter is doing well. Report It

I would try the picc line. If not, she will have to be stuck every time she goes in for antibiotics. I assume they will be doing it every day for 3 weeks. They cannot leave IV's in your arms, she will have to be stuck every time she goes in. That is 21 sticks. She will lose all her veins---they'll all collapse.

Yes, do the picc line. Just watch for any signs of infection.

this question is best answered by those caring for your daughter and you.

IV antibiotics delivered via a Peripherally Inserted Central Catheter (PICC) are going to better tolerated. In most cases a peripheral IV is only good for 72 hours based on many protocols. A PICC line would be a more reliable source of medication administration. Any invasive line has the potential to cause problems. I have maintained PICC lines for up to 8 months. I would request a closed ended or valved (Groshong) catheter. This type of catheter is less likely to cause complications.

I think a PICC line is a valid option. If she doesn't have one, she will have to be stuck over and over for peripheral IVs. Be advised though that PICC line insertion is a surgical procedure and with all surgeries come the risk of infection. Talk to your daughter's cardiologist.