Peripherally inserted central catheter placement in neonates with persistent left superior vena cava: Report of eight cases

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.