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Positioning of long lines
  1. N M Mehta,
  2. R M Nicholl
  1. Neonatal Intensive Care Unit, Northwick Park Hospital, NorthWest London Hospitals NHS Trust, Harrow HA1 3UJ, UK;

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    We read the article by Reece et al1 and followed the subsequent correspondence with interest. In the light of the recent review commissioned by The Chief Medical Officer for England, physicians must be aware of potential complications of peripherally inserted central catheters (PICCs).2 Although the true incidence of such events will only be known with prospective data collection, retrospective studies suggest a complication rate (pleural/pericardial effusions) of 0.5% per line insertion.3 The Department of Health (DoH) paper in response to this review recommends placement of central venous lines outwith the cardiac chambers.4 However, complications related to central lines are not only confined to the thorax. We report three cases of delayed detection of peritoneal extravasation related to central venous catheters.

    Case 1. An 8 week old malnourished infant was intubated and ventilated for acute onset severe respiratory …

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