Improvement of ultrasound positioning technique for peripherally inserted central catheter tip position in neonates / 中华实用儿科临床杂志

ABSTRACT

Objective:To explore a new method of ultrasound-guided positioning of the tip of neonatal peri-pherally inserted central catheter (PICC).Methods:Clinical data of 174 newborn infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Beijing Chaoyang District Maternal and Child Healthcare Hospital from January 2019 to April 2021 receiving PICC catheter intubated under the guidance of ultrasound for positioning the tip were retrospectively analyzed to explore the accuracy, reliability and feasibility of the improved ultrasound-guided positioning technique.Before lower extremity catheterization, ultrasound was performed to monitor the vascular pattern and catheterization of PICC was conducted under the guidance of ultrasound.Results:(1) Among 174 infants intubated with ultrasound-guided positioning of the PICC tip, 172(98.9%) of them had the ideal position, and 2(1.1%) did not achieve the ideal position, but achieved the ideal position after ultrasound-guided correction.(2) Lower extremity venous catheterization was successfully performed at 100.0% after ultrasound-guided monitoring of blood vessels.The time-consuming of lower extremity venous catheterization was significantly shorter than that of the previous method [(31.50±2.58) min vs.(56.10 ±5.30 min)]( t=46.84, P<0.001). The total success rate of catheterization and catheterization of lower limb vein increased by 7.0% and 17.5%, respectively.(3) Only 1 (0.57%) case reported the complication of catheter tip thrombosis, the complication rate of which decreased from the previous 79.00% to 2.70%(2/112 cases). Conclusions:The improved ultrasound-guided positioning of the PICC tip is convenient, simple, faster and accurate, which enhances the success rate and is worthy to be applied in clinical practice.