[Initial placement of the peripherally inserted central catheter's tip in neonates]

Area of Science:

• Neonatal Medicine
• Vascular Access
• Medical Devices

Context:

• Neonatal intensive care units (NICUs) require reliable vascular access for critically ill infants.
• Peripherally inserted central catheters (PICCs) are commonly used in neonates.
• Optimal tip placement is crucial for PICC efficacy and safety.

Purpose:

• To determine the initial tip position of peripherally inserted central catheters (PICCs) in neonates.
• To assess the success rate of PICC insertion in a neonatal population.
• To identify common malpositions of PICC tips in this patient group.

Summary:

• A cross-sectional study evaluated 37 neonates undergoing PICC insertion.
• The overall success rate for PICC insertion was 72.3%.
• Significant malpositions were observed, with 14.8% of tips in axillary/innominate veins and 11.1% in jugular veins. Upon removal, 48.2% of tips were in the right atrium, necessitating repositioning to the superior vena cava.

Impact:

• Findings highlight the need for improved techniques or imaging to ensure correct PICC tip placement in neonates.
• This data can inform clinical practice guidelines for PICC insertion and management in neonatal care.
• Understanding malposition prevalence can guide strategies to reduce complications associated with incorrect tip placement.