Comparison of formula‐based PICC catheterisation versus common method for the treatment of newborns

Abstract

Aims: Whether PICC in newborns can improve its success rate and reduce the complications by using the formula method to calculate the depth of catheterisation.Methods: A total of 130 newborns were prospectively studied from December 2018 to December 2019. All newborns were randomly divided into two groups that use formula method and common method respectively. The PICC catheter length of the two groups was observed. The unplanned extubation rate, one-time puncture success rate, catheter indwelling time, complications, duration of hospital stays and pain scores were recorded during the whole research process and compared between these two groups. Results:The formula method significantly improved the puncture success rate and reduced the secondary adjustment rate. The length of the catheter adjustment was significantly lower than the control group. The retention time also increased significantly. The incidence of PICC-related complications, including phlebitis, thrombosis, catheter-related infection and catheter displacement, was significantly reduced by using the formula method. Conclusions:The formula method in neonatal PICC catheter had great outcomes in terms of improving the success rate of one-time puncture and prolonging the indwelling time of catheter. What's knownPeripherally inserted central catheter (PICC) is an effective and safe infusion route for newborns, especially premature infants or those with very low birth weight What's newThis study showed that the formula method could significantly reduce the probability of secondary adjustment of indwelling catheter, reduce the pain score and the occurrence of related side effects.

Prevention of complications related to peripherally inserted central catheter insertion techniques in newborns: systematic review and network meta-analysis

“…Regarding the study designs, six were randomized controlled trials ( 14 , 35 - 36 , 38 - 40 ) and two were non-randomized trials ( 28 , 37 ) .…”

“…The samples varied within the neonate population, three studies only evaluated the insertion techniques in preterm ( 28 ) and very preterm/extreme preterm ( 38 - 39 ) NBs and four assessed the insertion techniques in preterm and full-term NBs ( 14 , 35 , 37 , 40 ) . One study only cited the mean weight of 2,500 g on the insertion day ( 36 ) .…”

“…The PICC insertion techniques in NBs found in the studies included were the following: intracavitary electrocardiogram (IC-ECG) to guide the tip ( 14 , 35 ) ; intracavitary electrocardiogram with ultrasound for vascular visualization (IC-ECG/USG) ( 28 , 37 ) ; real-time ultrasound (USGRT) to visualize the tip during insertion and guiding it ( 38 - 39 ) ; modified anatomical landmark (AL), in which the intervention took place with measurement of the catheter size to be inserted with a different anatomical framework ( 40 ) ; formula use, in which an equation determines the catheter length that must be inserted associated with performing a warm compress for 15 minutes at the insertion site before the puncture ( 36 ) ; and puncture guided by anatomical landmarks, characterized by blind puncture (without the aid of technologies), measurement by arm (the number of catheter centimeters to be inserted is predetermined by a measurement performed on the body surface from the probable insertion site to the superior or inferior vena cava) and visualization of the tip by x-ray ( 14 , 28 , 35 - 40 ) , which was the control group of all studies. In other words, the comparator/control in all studies was the same technique, which led the network to a star-shaped geometry.…”

“…The randomized trials showed some concerns regarding the randomization process due to some differences in the characteristics of the participants ( 38 ) , lack of detailed information in the articles ( 36 ) or 1:1 allocation ( 14 ) . It was not possible for the professionals who applied the intervention to be blinded, as they would need to know what the intervention was to apply it, with the exception of one study ( 40 ) .…”

Effectiveness and safety of intracardiac electrocardiogram guidance for epicutaneo-cava catheters via the lower extremity in preterm infants: a retrospective study

“…The ECC reference length is generally estimated by anatomical landmarks or through the formula method [ 25 , 29 – 31 ]. In this study, the ECC reference length was based on anatomical markers, while the actual insertion length was determined by IC-ECG, and the difference between the two was statistically significant ( P < 0.001).…”