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Risk factors for peripherally inserted central catheter malposition in preterm infants: a multicenter retrospective
Chunyan Liang1, Jinming Liu1, Yingzi Tang2
1Nursing Department, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Frontiers in Pediatrics
|March 24, 2025
Summary
Peripherally inserted central catheter (PICC) tip malposition occurred in 12.56% of preterm infants. Risk factors include specific locations, longer insertion/dwell times, lower weight percentile, extreme prematurity, and neck catheterization site.
Area of Science:
- Neonatal care
- Vascular access devices
- Medical device safety
Background:
- Peripherally inserted central catheters (PICCs) are crucial for preterm infants requiring long-term intravenous therapy.
- PICC tip malposition is a significant complication, potentially leading to reduced efficacy and increased risks.
- Identifying risk factors is essential for improving placement success rates and patient outcomes.
Purpose of the Study:
- To investigate the incidence of peripherally inserted central catheter (PICC) tip malposition in preterm infants.
- To identify clinical risk factors associated with PICC tip malposition in this vulnerable population.
Main Methods:
- Retrospective analysis of clinical data from 1,449 preterm infants undergoing PICC placement across multiple hospitals (January 2021 - April 2024).
- Statistical analysis including multifactorial and multimodel logistic regression to determine influencing factors.
- Comparison between infants with malpositioned and correctly positioned PICC tips.
Main Results:
- The overall incidence of PICC tip malposition was 12.56% (182/1,449).
- Significant risk factors identified include: specific sample selection locations (Guilin, Yulin, Qinzhou), longer duration of catheter insertion and dwell, lower weight percentile, extreme prematurity (<28 weeks gestation), and PICC catheterization at the neck site.
- Odds ratios indicated substantial increased risk associated with these factors.
Conclusions:
- Specific geographical locations, procedural durations, patient weight percentile, gestational age, and catheterization site are significant risk factors for PICC tip malposition in preterm infants.
- These findings highlight the need for targeted strategies to mitigate malposition risks during PICC placement in neonates.
- Further research and protocol refinement are warranted to improve the safety and effectiveness of PICC use in preterm infants.
