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• W2188330753 abstract "Background: Peripherally inserted central venous catheters (PICCs) placed in a noncentral position are associated with higher complication rates, and cannot be used like PICCs in a correct central position. The purpose of this study was to analyze the tip position of blindly inserted PICCs in neonates, and to evaluate factors that influence the rate of correct central positioning. Patients and methods: Over a 29 month period, 691 neonates who were treated in the NICU were analyzed. Catheter tip position was determined by chest X-ray; in cases with questionable positioning, sonography or a second X-ray with contrast material was performed. A correct central position was defined as a PICC tip position anywhere in the superior or the upper inferior caval vein. Results: During the study period, 174 PICCs were inserted in 127 neonates. Of these, 111 (63.8%) PICCs were found to have noncentral initial tip positioning. Following correction, 107 (61.5%) PICCs had a correct central tip position. The rate of central positioning was not influenced by gestational age, weight, side (left or right) of insertion, head position, catheter size, mechanical ventilation, or sedation. The rate of correct central positioning was higher when using a lower compared with an upper extremity access (p # 0.01). Insertion-related problems were associated with a lower positioning success rate at the initial but not second radiograph (p = 0.019). Insertion via the basilic vein was superior to the cephalic vein for achieving correct tip position following correction (p = 0.027). Conclusions: In term and preterm infants, correct central positioning of PICCs is possible in most patients, but corrections are often necessary because of initial malpositioning. Further studies are needed to identify strategies to decrease noncentral PICC positions, especially for blind, bedside PICC insertions in neonates." @default.
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• W2188330753 date "2010-01-01" @default.
• W2188330753 modified "2023-09-24" @default.
• W2188330753 title "Malpositioning in blindly inserted PICCs in neonates. Experience in 174 catheters" @default.
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