Correct tip location is crucial for a peripherally inserted central catheter (PICC) to maximize the effects of central venous infusion” Zhou et al (2017).
Correct tip location is crucial for a peripherally inserted central catheter (PICC) to maximize the effects of central venous infusion. However, it is difficult to place the tip in a correct location in neonates because of the unreliable estimated length by surface landmark.
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Therefore, we evaluated the feasibility and safety of an improved intracavitary electrocardiogram (IC-ECG) technique in guiding PICC placement in neonates based on the ratios of P/R wave amplitudes on IC-ECG. The results showed that all of the 32 neonates whose PICCs had been successfully placed and correct tip position verified by chest radiography acquired qualified P wave on IC-ECG. The average ratio of P/R wave amplitude was 0.6 ± 0.1, with a range of 0.4 to 0.8. The 49 neonates who received IC-ECG-guided PICC catheterization showed higher success rates of correct PICC tip position on the first attempt than traditional, predetermined length estimation on surface landmark (93.9% vs 62.5%, χ = 18.01, P < .001). No significant complications occurred in the studied neonates. Based on these findings, IC-ECG-guided tip placement appears to be a promising approach in improving the success rate of tip location when placing a PICC in neonates.
Zhou, L., Xu, H., Liang, J., Xu, M. and Yu, J. (2017) Effectiveness of Intracavitary Electrocardiogram Guidance in Peripherally Inserted Central Catheter Tip Placement in Neonates. The Journal of Perinatal & Neonatal Nursing. May 17th. [epub ahead of print].
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