Effectiveness of a Modified Measurement of the Peripherally Inserted Central Catheter in Newborns: A Randomized Study

2021 ◽  
Author(s):  
Andreia Tomazoni ◽  
Patrícia Kuerten Rocha ◽  
Sabrina de Souza ◽  
Juliana Coelho Pina ◽  
Camila Biazus Dalcin
Keyword(s):  
Neonatal Intensive Care ◽  
Measurement Method ◽  
Randomized Study ◽  
Future Research ◽  
Control Group ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Initial Location ◽  
Catheter Tip ◽  
Experimental Group

Highlights Abstract Introduction: The measurement recommended in literature for a peripherally inserted central catheter presents considerable rates of poor positioning in the neonatal population. Objective: To evaluate the effectiveness of the modified measurement method for a peripherally inserted central catheter in newborns, with respect to the positioning of the catheter tip. Method: A randomized clinical trial, conducted in a Neonatal Intensive Care Unit in south Brazil. The sample comprised the number of catheter insertion procedures in newborns, being randomized in the control group by applying the traditional measure and in the experimental group by applying a modified measure. The sample included 155 procedures, with 88 procedures included in data analysis. The data collection period was from September 2018 to September 2019. Results: The group-related variable was considered a risk factor for tip location. The control group was 28.87 times more likely to have the tip’s initial location peripheral than the experimental group, and 44.80 times more likely that the location would be intracardiac than in the experimental group. Conclusions: The modified measurement method proved to be more effective for the central location of the tip. The need for new assessments of this method in future research studies is highlighted.

Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial

2019 ◽  
Vol 21 (4) ◽  
pp. 511-519
Author(s):  
Can Dai ◽  
Jia Li ◽  
Qiu-mei Li ◽  
Xiuquan Guo ◽  
Yu-ying Fan ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Controlled Trial ◽  
Prospective Trial ◽  
Catheter Placement ◽  
Control Group ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Randomized Controlled ◽  
Catheter Dislodgement ◽  
Experimental Group

Purpose: To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound. Methods: A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat. Results: A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, P = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, P = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, P < 0.001), a lower incidence of medical adhesive–related skin injury (9.2% vs 25.3%, P = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, P = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, P = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months ( P < 0.05). Conclusion: Tunneled peripherally inserted central catheter may be recommended for good effectiveness.

Electrocardiogram-Guided Peripherally Inserted Central Catheter Tip Confirmation Using a Standard Electrocardiogram Machine and a Wide-Mouth Electrocardiogram Clip Compared with Traditional Chest Radiograph

2016 ◽  
Vol 21 (1) ◽  
pp. 44-54 ◽  
Author(s):  
Yvonne K. Cales ◽  
Jennifer Rheingans ◽  
Janet Steves ◽  
Mary Moretti
Keyword(s):  
Superior Vena Cava ◽  
Chest Radiograph ◽  
Superior Vena ◽  
Vena Cava ◽  
P Wave ◽  
Control Group ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Wide Mouth ◽  
Experimental Group

Abstract Objective: The purpose of this institutional review board-approved, single-blinded, randomized controlled trial was to evaluate the effectiveness of bedside peripherally inserted central catheter (PICC) tip placement using a nonproprietary electocardiogram (EKG) machine and wide-mouth EKG clip connected to the right arm lead and PICC guide wire. The hospital site in this study was an 800-bed community, nonacademic, Magnet hospital in the southeastern United States. Methods: All patients who provided consent and were eligible for bedside PICC insertion were randomly assigned to either standard PICC insertion or standard PICC insertion plus EKG guidance. Placement was identified by observing for P wave changes, which indicated PICC tip location in relationship to the sinoatrial node in the superior vena cava. After the PICC lines were placed, 2 radiologists blinded to treatment assignment independently reviewed confirmatory chest radiographs. De-identified data were collected and analyzed. Results: One hundred eighty-seven patients participated in this study. Of all patients, 94.6% had a baseline rhythm with a discernable P wave. The time to insert the PICC while using EKG guidance increased by a mean difference of 9 minutes (P = .001). The time to notification of the floor nurse that the PICC was read by a radiologist and ready to use for infusions was not significant between groups. In the control group, 91.8% of PICC lines were placed to completion at the bedside vs 90.2% in the experimental group (P = .710). PICCs placed with EKG guidance were successfully placed with the first attempt or 1 pass (89%; n = 91) vs PICCs placed without EKG guidance (75%; n = 63; P = .01). Of the control group, 40% (n = 34) and of the experimental group, 48% (n = 49) had PICC lines placed within 1.5 cm of the sinoatrial junction. Of the control group, 53% (n = 45) and of the experimental group, 65% (n = 66) had PICC lines placed within 1.5 cm of the sinoatrial junction to 3.0 cm above the sinoatrial junction (P = .10). Of the control group, 64.8% (n = 55) and of the experimental group, 82.2% (n = 84) had PICC lines placed within 1.5 cm of the sinoatrial junction to 6.0 cm above the sinoatrial junction (P =.3). Of the control group, 7.1% (n = 6) and of the experimental group, 2.9% (n = 3) had PICC lines placed 6.1 cm or more above the sinoatrial junction. Of the control group, 18.8% (n = 16) and of the experimental group, 8.8% (n = 9) had PICC lines placed too deep in the superior vena cava and below 1.6 cm (P &lt; .05). PICCs inserted with or without EKG guidance statistically had the same amount of chest radiograph images performed (P =.083). Three groups reviewed the chest radiographs to determine the PICC tip location and they agreed to the location 82% of the time and a significant positive correlation between all 3 groups existed. The PICC Team subjectively identified 22 patients as obese. No statistical significance was realized among patients not identified as obese vs those identified as obese. Conclusions: The data revealed that the control and experimental groups were equally distributed for baseline demographic characteristics such as sex and age. Importantly, it was determined that 94% of participants had a discernable P wave and were candidates for the use of EKG guidance. The time to insert a PICC line at bedside with the use of EKG guidance increased the procedure time by a mean of 9 minutes; however, the ultimate infiuence on patient care resulted in a savings of 67 minutes after factoring in an average of 76 minutes for radiograph confirmation. Complications and the need to reposition PICC lines were not found to be significant or vastly different or improved with or without the use of EKG guidance. PICC lines placed with the use of EKG guidance were significantly unlikely to be repositioned. Lastly, it was found that obesity did not play any particular role. Based on these findings, the facility determined that EKG guidance is effective and its use was implemented for all bedside PICC placements in which a P wave was discernable.

278 PERIPHERALLY INSERTED CENTRAL CATHETER TIP LOCATION IN NEONATES

2005 ◽  
Vol 53 (1) ◽  
pp. S127.1-S127
Author(s):  
P. Fliman ◽  
R. deRegnier ◽  
M. DeUngria ◽  
R. Shore ◽  
R. Steinhorn
Keyword(s):  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip

scholarly journals The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns

2015 ◽  
Vol 23 (3) ◽  
pp. 475-482 ◽  
Author(s):  
Priscila Costa ◽  
Amélia Fumiko Kimura ◽  
Debra Huffman Brandon ◽  
Eny Dorea Paiva ◽  
Patricia Ponce de Camargo
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Neonatal Intensive Care ◽  
Operating Characteristic ◽  
Bivariate Analysis ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Single Lumen ◽  
Double Lumen Catheter ◽  
Lumen Catheter

OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns.METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve.RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76.CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.

scholarly journals Cateter central de inserção periférica e dissecção venosa em bebês: estudo descritivo

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Keline Soraya Santana Nobre ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Juliana Lopes Teixeira ◽  
Márcia Maria Coelho Oliveira Lopes ◽  
Fernanda Cavalcante Fontenele
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Quantitative Study ◽  
Neonatal Unit ◽  
Northeastern Brazil ◽  
Maternity Unit ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip

Aim:  analyze  the  use  of  peripherally  inserted  central  catheter  in terms of the aspects of technique, positioning and maintenance, as well as the influence on the number of venous dissections in hospitalized infants in a neonatal unit. Method: descriptive,  retrospective,  quantitative  study,  in  reference  maternity  unit  of  a  city  in northeastern  Brazil.  Sample  composed  of  1,599  peripherally  inserted  central  catheter insertions in 1,204 infants during the years 2006 to 2013. Instruments were used that recorded  aspects  of  the  insertion  of  peripherally  inserted  central  catheter  and  venous dissection.  Results:  most  babies  were  premature,  of  low  birth  weight  and  male.  The veins  of  the  cubital  region  were  the  most  punctured  with  insertion  success  until  the fourth  puncture.  The  central  positioning  of  the  catheter  tip predominated,  with  a permanency  time  between  11  and  20  days,  removing  it  at  the  end  of  the  treatment. Over  the  years,  the  number  of  venous  dissections  was  inversely  proportional  to  the insertion  of  peripherally  inserted  central  catheter.  Conclusion:  this  transvenous  device was  shown  to  be  important  for  the  treatment  of  hospitalized  newborns,  favoring reduction of venous dissections.

scholarly journals Methods for measuring venous peripherally inserted central catheters in newborns

2022 ◽  
Vol 75 (2) ◽  
Author(s):  
Andreia Tomazoni ◽  
Patrícia Kuerten Rocha ◽  
Mavilde da Luz Gonçalves Pedreira ◽  
Elisa da Conceição Rodrigues ◽  
Bruna Figueiredo Manzo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Neonatal Intensive Care ◽  
Descriptive Analysis ◽  
Institutional Review Board ◽  
Central Catheter ◽  
Peripherally Inserted Central Catheters ◽  
Institutional Review ◽  
Significant Difference ◽  
Catheter Tip ◽  
Central Catheters

ABSTRACT Objective: to analyze the results of insertion procedures of Peripherally Inserted Central Catheters in newborns using two measurement methods. Methods: this is a randomized clinical trial, presenting descriptive and exploratory results of variables. It was held at a Neonatal Intensive Care Unit. Data were collected between September 2018 and 2019. The sample analyzed was 88 catheter insertion procedures, distributed in two groups. Study approved by an Institutional Review Board and obtained registration in the country and abroad. Descriptive analysis and logistic regression of data. Results: modified measurement obtained a significant difference for the central catheter tip location. Elective removals and adverse events were not significant between groups; however, poor positioning was related to adverse events. Conclusions: between the two methods analyzed, the modified measurement obtained better results in the proper catheter tip positioning and, consequently, less risk to patients.

scholarly journals Peripherally inserted central catheter tip position and risk of associated complications in neonates

2012 ◽  
Vol 33 (4) ◽  
pp. 307-312 ◽  
Author(s):  
A Jain ◽  
P Deshpande ◽  
P Shah
Keyword(s):  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip ◽  
Tip Position

Limited Ultrasound Protocol for Upper Extremity Peripherally Inserted Central Catheter Monitoring: A Pilot Study in the Neonatal Intensive Care Unit

2018 ◽  
Vol 38 (5) ◽  
pp. 1341-1347 ◽  
Author(s):  
Patrick Motz ◽  
Amelie von Saint Andre von Arnim ◽  
Maggie Likes ◽  
Shilpi Chabra ◽  
Christopher Traudt ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Upper Extremity ◽  
Neonatal Intensive Care ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter

Comparing of the reduction accuracy of marker-3D measurement method and traditional radiograph measurement method in the treatment of patients with tibia fracture treated with Taylor Spatial Frame: a retrospective study

2020 ◽  
Author(s):  
QiXin Liu ◽  
Hong Li ◽  
SiDa Liu ◽  
XueFei Fu ◽  
YanShi Liu ◽  
...  
Keyword(s):  
Measurement Method ◽  
Tibia Fracture ◽  
Taylor Spatial Frame ◽  
Lateral Radiograph ◽  
Control Group ◽  
X Rays ◽  
3D Measurement ◽  
Spatial Frame ◽  
Group Control Group ◽  
Experimental Group

Abstract Background The Taylor Spatial Frame (TSF) has been widely used on tibia fractures. However, traditional radiograph measurement method is complicated and the reduction accuracy is not high enough for correcting residual deformities. We proposed the marker-3D measurement method to solve these problems. This study aimed to compare the reduction accuracy of the traditional radiograph measurement method and the marker-3D measurement method in tibia fracture treated with TSF. Methods From January 2016 to June 2019, A retrospective analysis was performed based on the patients with tibia fracture treated with TSF in Tianjin Hospital. Forty-one patients were qualified for this study, including 21 patients in the marker-3D measurement group (experimental group) and 20 patients in the traditional radiograph measurement group (control group). In the experimental group, CT scan was performed for 3D reconstruction with 6 markers installed on the TSF, to determine the adjusting plan; in the control group, the Anteroposterior (AP) and Lateral radiographs were performed for the deformity parameters. All fractures were corrected after TSF adjusting, and then X-rays were taken to measure the residual deformities. Results All patients reached functional reduction. The residual displacement deformity (RDD) in AP radiograph was 0.5 (0, 1.72) mm in experimental group and 1.74 (0.43, 3.67) mm in control group; the residual angle deformity (RAD) in AP radiograph was 0 (0, 1.25) ° in experimental group and 1.25 (0.62, 1.95) °in control group. As to the Lateral radiograph, the RDD was 0 (0, 1.22) mm in experimental group and 2.02 (0, 3.74) mm in control group; the RAD was 0 (0, 0) ° in experimental group and 1.42 (0, 1.93) ° in control group. Significant differences in all above comparisons were found between the groups (AP radiograph RDD: P = 0.024, RAD: P = 0.020; Lateral radiograph RDD: P = 0.016, RAD: P = 0.004). Conclusion Both groups achieved satisfactory fracture reduction. However, the residual deformities in the experimental group were significantly smaller. This study proved that the marker-3D measurement method could further improve the accuracy of the reduction.

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