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Recommendations for Peripherally Inserted Central Catheter Insertion Depths in Neonates.

Alexandra Luister¹, Neda Khostwal¹, Philipp Deindl¹

¹Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Martinistreet, Hamburg, Germany.

|January 3, 2023

Summary

This study developed simple charts and tables to guide the correct insertion depth for peripherally inserted central catheters (PICCs) in neonates, simplifying a previously complex process.

Keywords:

Neonate Parenteral nutrition Peripherally inserted central catheter Reference values

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Area of Science:

Neonatal Medicine
Pediatric Critical Care
Vascular Access

Background:

Malposition of peripherally inserted central catheters (PICCs) is a frequent complication in neonates.
Existing recommendations for PICC insertion depths are often complex and lack practical guidance.

Purpose of the Study:

To develop user-friendly diagrams and tables for determining optimal PICC insertion depths in neonates.
To base these recommendations on readily available anthropometric parameters.

Main Methods:

A retrospective analysis of 204 neonates undergoing PICC insertion.
Correlation of optimal PICC insertion depths with body weight, length, and head circumference.
Development of line charts and tables using linear regression analysis.

Main Results:

Analysis included 204 infants (gestational age 24.0-44.9 weeks), with 131 PICCs in upper and 73 in lower extremities.
Linear logistic regression models yielded R2 values ranging from 0.387 to 0.884, indicating good correlation.
Generated charts and tables provide a practical tool for depth determination.

Conclusions:

The developed charts and table offer a fast and accurate method for recommending PICC insertion depths in neonates.
Simplifies the process, potentially reducing malposition complications.