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Reducing Peripherally Inserted Central Catheter Tip Migration in Neonates: A Proactive Approach to Detection and
Debbie Diewo1,2, John Mawson3, Sandesh Shivananda2
1Department of Pediatrics, Sarawak General Hospital, Kuching 93586, Malaysia.
Journal of Clinical Medicine
|March 27, 2025
Summary
Peripherally Inserted Central Catheter (PICC) tip migration occurred in 30% of infants within hours of placement. A proactive approach successfully repositioned 83% of migrated PICC tips without complications.
Area of Science:
- Neonatal medicine
- Pediatric vascular access
- Radiology
Background:
- Peripherally Inserted Central Catheters (PICCs) are crucial for neonatal care.
- PICC tip migration is a common complication, potentially leading to adverse events.
Purpose of the Study:
- To quantify PICC tip migration in infants within 3-7 hours post-insertion.
- To evaluate the effectiveness of manual adjustments for repositioning migrated PICC tips.
Main Methods:
- Retrospective study of 712 infants receiving PICCs.
- Standardized imaging protocols, target tip locations, and radiological surveillance.
- Guided manual adjustments for repositioning.
Main Results:
- PICC tip migration occurred in 30% of infants (n=211) within 3-7 hours.
- Inward migration into the cardiac silhouette was most common (81%).
- Manual adjustments successfully repositioned 83% of migrated PICCs (n=191) without pericardial effusion.
Conclusions:
- A proactive approach with standardized protocols effectively detects PICC tip migration.
- Manual adjustments are a successful strategy for repositioning migrated PICC tips in infants.
- This approach minimizes risks associated with PICC malposition.
