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Reducing Peripherally Inserted Central Catheter Tip Migration in Neonates: A Proactive Approach to Detection and Repositioning Diewo, Debbie; Mawson, John; Shivananda, Sandesh
Abstract
Objective: Peripherally Inserted Central Catheter (PICC) tip migration often occurs after placement despite efforts to position the tip centrally. This study aimed to quantify PICC tip migration within 3–7 h post-insertion and evaluate the effectiveness of manual adjustments for repositioning. Methods: This single-centre retrospective study evaluated the impact of a proactive approach following PICC placement, which included standardized body positioning during X-rays, defined target PICC tip locations, radiological surveillance at 4–6 h post-insertion, and guided manual adjustments. We included all infants receiving PICCs during a five-year period; trained nurses and physicians in vascular access performed the insertions. Results: Of 712 infants included, the median gestational age was 30 weeks, and the median birth weight was 1386 g. PICC tip migration occurred in 211 infants (30%) within 3–7 h post-insertion, with 81% of cases involving inward migration into the cardiac silhouette. Migration was more common in upper limb PICCs (82%). Manual adjustments achieved satisfactory repositioning in 191 infants (83%). None of the infants experienced pericardial effusion. Conclusions: A proactive approach that standardized imaging protocols, timing, and PICC tip positioning detected migration in 30% of infants and successfully facilitated repositioning in 83% of cases.
Item Metadata
Title |
Reducing Peripherally Inserted Central Catheter Tip Migration in Neonates: A Proactive Approach to Detection and Repositioning
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Creator | |
Contributor | |
Publisher |
Multidisciplinary Digital Publishing Institute
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Date Issued |
2025-03-11
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Description |
Objective: Peripherally Inserted Central Catheter (PICC) tip migration often
occurs after placement despite efforts to position the tip centrally. This study aimed to
quantify PICC tip migration within 3–7 h post-insertion and evaluate the effectiveness of
manual adjustments for repositioning. Methods: This single-centre retrospective study
evaluated the impact of a proactive approach following PICC placement, which included
standardized body positioning during X-rays, defined target PICC tip locations, radiological
surveillance at 4–6 h post-insertion, and guided manual adjustments. We included all
infants receiving PICCs during a five-year period; trained nurses and physicians in vascular
access performed the insertions. Results: Of 712 infants included, the median gestational
age was 30 weeks, and the median birth weight was 1386 g. PICC tip migration occurred in
211 infants (30%) within 3–7 h post-insertion, with 81% of cases involving inward migration
into the cardiac silhouette. Migration was more common in upper limb PICCs (82%).
Manual adjustments achieved satisfactory repositioning in 191 infants (83%). None of
the infants experienced pericardial effusion. Conclusions: A proactive approach that
standardized imaging protocols, timing, and PICC tip positioning detected migration in
30% of infants and successfully facilitated repositioning in 83% of cases.
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Subject | |
Genre | |
Type | |
Language |
eng
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Date Available |
2025-05-05
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Provider |
Vancouver : University of British Columbia Library
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Rights |
CC BY 4.0
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DOI |
10.14288/1.0448745
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URI | |
Affiliation | |
Citation |
Journal of Clinical Medicine 14 (6): 1875 (2025)
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Publisher DOI |
10.3390/jcm14061875
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Peer Review Status |
Reviewed
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Scholarly Level |
Faculty; Researcher
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Rights URI | |
Aggregated Source Repository |
DSpace
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Item Media
Item Citations and Data
Rights
CC BY 4.0