Analysis of factors related to tip malposition of peripherally inserted central catheter and its spontaneous correction rate in neonates

Abstract

Background: To analyze the factors associated with tip malposition and spontaneous correction rate of peripherally inserted central catheter (PICC) in newborns.

Methods: Clinical data of 1604 newborns who underwent PICC placement in our neonatal surgery department from January 2018 to January 2023 were retrospectively analyzed. They were divided into malposition group (n=104) and normal group (n=1500) according to the occurrence of tip malposition. The relevant clinical data of newborns were extracted from the hospital information system. The occurrence of PICC tip malposition and spontaneous correction were recorded. Logistic regression analysis was used to identify risk factors for PICC tip malposition in newborns.

Results: The incidence of PICC malposition was 6.48%. There were significant differences in gestational age, birth weight, lesion location, catheter direction and venous placement between the two groups (P<0.05). The independent risk factors for PICC tip malposition in newborns were lesion location, catheter direction and venous placement (P<0.05). The spontaneous correction rate within 24 hours was 27.88%, with the highest rate observed in malposition of the internal jugular vein.

Conclusion: Catheter direction, lesion location and venous placement are independent risk factors for PICC tip malposition in newborns, and some newborns may spontaneously correct within 24 hours.

Keywords: Peripherally inserted central catheter; neonatal care; spontaneous correction; tip malposition.