RCT of Reduction in Catheter-Related Complications by Using Intracavitary Electrocardiogram-Assisted Guidance in Neonatal PICC Placement

TANG Bin-zhi; CHEN Chang-hui; CHEN Hong; LING Qi-ying

doi:10.12182/20210560506

Volume 52 Issue 3

May 2021

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JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2021 > 52(3): 497-502. > DOI: 10.12182/20210560506

TANG Bin-zhi, CHEN Chang-hui, CHEN Hong, et al. RCT of Reduction in Catheter-Related Complications by Using Intracavitary Electrocardiogram-Assisted Guidance in Neonatal PICC Placement[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(3): 497-502. DOI: 10.12182/20210560506

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RCT of Reduction in Catheter-Related Complications by Using Intracavitary Electrocardiogram-Assisted Guidance in Neonatal PICC Placement

1.
Department of Pediatrics, School of Medicine, University of Electronic Science and Technology of China/Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu 610072, China
2.
Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, Chengdu 610041, China

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Corresponding author:
LING Qi-ying, E-mail: lingqiying@med.uestc.edu.cn
Received Date: January 13, 2020
Revised Date: August 25, 2020
Available Online: May 18, 2021
Published Date: May 19, 2021

Abstract

Abstract

Objective To investigate the effect of intracavitary electrocardiogram (IC-ECG) guidance on peripherally inserted central catheter (PICC) related complications in neonatal patients.
Methods A total of 210 neonatal patients were included in the study. They were admitted to the Neonatal Intensive Care Unit, Sichuan Provincial People's Hosptial between January, 2017 and December, 2019 and had PICC lines were placed in their upper limbs. The patients were randomly assigned to the observation group, which had PICC placement through conventional anatomical landmark guidance combined with IC-ECG guidance (n=105) or to the control group, which had PICC placement through only conventional anatomical landmark guidance (n=105) for PICC catheter tip positioning. Patient baseline data and data on subsequent catheter-related complications of the two groups were collected and compared.
Results There were no significant difference between the two groups in sex composition, gestational age, postnatal days on the day of PICC placement, duration of PICC placement, disease profile, and the site of puncture (P>0.05). The observation group showed a significantly lower overall incidence of catheter-related complications (3.8%), compared to that of the control group (21.9%) (P<0.05). The observation group showed significantly lower incidence of phlebitis and arrhthmia compared to that of the control group (P<0.05).
Conclusion A combination of anatomical landmark guidance and IC-ECG guidance to assist the placement of PICC decreases catheter-related complications.

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[1]	SMAZAL A L, KAVARS A B, CARLSON S J, et al. Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants. Pediatr Res,2016,80(2): 185–189. DOI: 10.1038/pr.2016.73
[2]	CAMARA D. Minimizing risks associated with peripherally inserted central catheters in the NICU. MCN Am J Matern Child Nurs,2001,26(1): 17–21. DOI: 10.1097/00005721-200101000-00005
[3]	YAMAGUCHI R S, NORITOMI D T, DEGASPARE N V, et al. Peripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis. Care Med,2017,43(8): 1097–1104. DOI: 10.1007/s00134-017-4852-7
[4]	姜红, 杨凡, 姜楠, 等. 早产儿上肢外周中心静脉置管术后体位对导管尖端定位的影响: 附二例临床分析. 中国小儿急救医学,2015,22(1): 63–65. DOI: 10.3760/cma.j.issn.1673-4912.2015.01.018
[5]	徐兵, 杨丽娟, 戴明红. 心电监护仪在新生儿PICC 导管尖端定位中的应用. 蚌埠医学院学报,2015,40(10): 1432–1434. DOI: 10.13898/j.cnki.issn.1000-2200.2015.10.046
[6]	ZHOU L J, XUA H Z, XU M F, et al. An accuracy study of the intracavitary electrocardiogram (IC-ECG) guided peripherally inserted central catheter tip placement among neonates. Open Med (Wars),2017,12: 125–130. DOI: 10.1515/med-2017-0019
[7]	ZHOU L, XU H, LIANG J, et al. Effectiveness of intracavitary electrocardiogram guidance in peripherally inserted central catheter tip placement in neonates. J Perinat Neonatal Nurs,2017,31(4): 326–331. DOI: 10.1097/JPN.0000000000000264
[8]	凌其英, 陈虹, 唐敏, 等. 心电监护仪在新生儿PICC置管中的定位效果. 中国当代儿科杂志,2018,20(5): 363–367. DOI: 10.7499/j.issn.1008-8830.2018.05.005
[9]	倪宗瓒. 医学统计学. 北京: 高等教育出版社, 2003: 117-118.
[10]	LING Q, CHEN H, TANG M, et al. Accuracy and safety study of intracavitary electrocardiographic guidance for peripherally inserted central catheter placement in neonates. J Perinat Neonatal Nurs,2019,33(1): 89–95. DOI: 10.1097/JPN.0000000000000389
[11]	楼晓芳. 吕华, 马美芳, 等经外周置人中心静脉导管在危重新生儿中的应用研究. 护士进修杂志,2007,22(23): 2119–2122. DOI: 10.3969/j.issn.1002-6975.2007.23.003
[12]	ROSSETTI F, PITTIRUTI M, LAMPERTI M, et al. The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study. J Vasc Access,2015,16(2): 137–143. DOI: 10.5301/jva.5000281
[13]	中华医学会重症医学分会. 血管内导管相关感染的预防与治疗指南(2007). 中国实用外科杂志,2008,28(6): 413–421. DOI: 10.3321/j.issn:0578-1426.2008.08.031
[14]	罗春绸, 陈开珠, 杨李娜, 等. 地塞米松溶液预处理外周静脉置入中心静脉导管预防早产儿静脉炎随机双盲对照试验. 中国循证儿科杂志,2013,8(5): 352–355. DOI: 10.3969/j.issn.1673-5501.2013.05.006
[15]	王丹虹. 新生儿肢体动脉血栓诊疗进展. 临床儿科杂志,2018,36(4): 311–315. DOI: 10.3969/j.issn.1000-3606.2018.04.017
[16]	王颍源, 康文清, 张耀东. 新生儿心律失常89例临床分析. 中华实用诊断与治疗杂志,2018,32(9): 896–898. DOI: 10.13507/j.issn.1674-3474.2018.09.019
[17]	OLIVER G, JONES M. ECG or X-ray as the ‘gold standard’ for establishing PICC-tip location? Br J Nurs, 2014, 23(Suppl 19): S10−S16.
[18]	WRIGHTSON D D. Peripherally inserted central catheter complications in neonates with upper versus lower extremity insertion sites. Adv Neonatal Care,2013,13(3): 198–204. DOI: 10.1097/ANC.0b013e31827e1d01
[19]	YUAN L, LI R, MENG A, et al. Superior success rate of intracavitary electrocardiogram guidance for peripherally inserted central catheter placement in patients with cancer: a randomized open-label controlled multicenter study. PLoS One,2017,12(3): e0171630[2019-12-21]. https://doi.org/10.1371/journal.pone.0171630.
[20]	WANG G, GUO L, JIANG B, et al. Factors Influencing Intracavitary Electrocardiographic P-Wave Changes during Central Venous Catheter Placement. PLoS One,2015,10(4): e0124846[2019-12-21]. https://doi.org/10.1371/journal.pone.0124846.
[21]	HSU J F, TSAI M H, HUANG H R, et al. Risk factors of catheter-related bloodstream infection with percutaneously inserted central venous catheters in very low birth weight infants: a center’s experience in Taiwan. Pediatr Neonatol,2010,51(6): 336–342. DOI: 10.1016/S1875-9572(10)60065-4
[22]	李娜, 付红平, 夏凡, 等. 新生儿下肢外周中心静脉导管相关并发症的影响因素分析. 中国医学前沿杂志(电子版),2019,11(5): 66–69. DOI: 10.12037/YXQY.2019.05-16
[23]	MILSTONE A M, REICH N G, ADVANI S, et al. Catheter dwell time and CLABSIs in neonates with PICCs: a multicenter cohort study. Pediatrics, 2013, 132(6): e1609–e1615[2019-12-21]. https://doi.org/10.1542/peds.2013-1645.
[24]	韦艳红, 王楠楠, 薛梅. 新生儿PICC导管相关性血流感染高危因素及预防研究进展. 中西医结合护理(中英文),2017,3(7): 182–185. DOI: 10.11997/nitcwm.201707061
[25]	周青, 江智霞, 代永娅, 等. 特征性P波在腔内心电图引导PICC尖端定位中的应用研究进展. 护理研究,2020,34(4): 641–646. DOI: 10.12102/j.issn.1009-6493.2020.04.015

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RCT of Reduction in Catheter-Related Complications by Using Intracavitary Electrocardiogram-Assisted Guidance in Neonatal PICC Placement

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