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PICC tip shift in the very low birth weight infants – Full Text

"There is a close correction between catheter tip shift and weight gain for those babies" Zhang et al (2020).
Abstract:

Background: Peripherally inserted central catheter (PICC) is one of the important ways to maintain nutrition in premature infants, especially for very low birth weight infants. There are studies have shown that as premature babies grow up after birth, the tip of the PICC will shift away from the heart. When the catheter remove from the central vein, the risk of complications is suddenly increased. Therefore, it is important to predict the position of catheter tip.

Methods: Select the very low birth weight infant (VLBW) infants who used PICC in our hospital from April 2017 to August 2018. And we recorded the birth weight, the weight and the position of the catheter tip of the each filming day, and calculated the rate and speed of weight gain during this period. The correlation was analyzed by the Spearman method.

Results: A total of 49 patients and 151 X-rays were enrolled in the study. Of the 49 remaining infants, 40 were in appropriate for gestational age group and 9 were in small for gestational age group. The correlation between weight gain and PICC tip shift in appropriate for gestational ages (AGAs) is statistically significant (P<0.05). But for SGAs group, the correlation between the rate of weight gain and PICC tip shift was -0.588 (P<0.05), but there was no correlation between the speed of weight gain and PICC tip shift.

Conclusions: There is a close correction between catheter tip shift and weight gain for those babies. The PICC should be repositioned by X-ray when the rate of weight gain of AGA infants increased to 25%, 50%, 70% [10%, 35%, 55% for small for gestational age (SGA) infants]. For AGAs, when the baby’s weight gain speed reaches 1% and 3.5%, the catheter tip had 2 and 3vertebral changes, so if the speed of weight gain is excessive faster, we need to increase the frequency of the positioning.

Reference:

Zhang M, Yang W, Yan L, Huang L, Lin N, Zhang S, He L. The correlation between weight gain and PICC tip shift in the very low birth weight infants. Transl Pediatr. 2020 Oct;9(5):596-602. doi: 10.21037/tp-20-5. PMID: 33209721; PMCID: PMC7658776.