American Journal of Pediatrics

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Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization

Received: Mar. 29, 2020    Accepted: Apr. 17, 2020    Published: Apr. 29, 2020
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Abstract

Objective: To compare the effects of Intracavitary Electrocardiography (IC-ECG) method and in vitro measurement for positioning the tip of Peripherally Inserted Central Catheter (PICC) in neonates, and investigate the influence of these two methods on PICC complications. Methods: Neonates who received PICC in the neonate intensive care unit of the First Affiliated Hospital of Jinan University from January 2015 to August 2019 were analyzed retrospectively. Patients were divided into two groups: the observation group with both IC-ECG method and in vitro measurement and the control group only with in vitro measurement. Chest X-ray were taken for both groups after the catheterization to confirm the catheter tip position. Statistics about catheter tip position, final extubation rate and PICC-related complications were collected and compared. Results: A total of 348 patients were enrolled (181 observation group, 167 control group). Two groups were comparable in terms of gender, gestational age, birth weight, catheterized side and vein during catheterization with no statistical significance. In the observation group, 173 (95.6%) had P-wave amplitude changes, including 4 (2.2%) were positioned at the upper 1/3 of the superior vena cava (SVC), 28 (15.5%) at the middle 1/3 of SVC, 104 (57.5%) at lower 1/3 of SVC; 38 cases (21.0%) at the right atrium or right ventricle, 7 (3.9%) at other parts, and the proportion of above situations in control group were 7 (4.2%), 15 (9.0%), 33 (19.8%), 48 (28.7%), and 47 (38.3%), respectively. The final extubation rate in the observation group was 86.2% (n=156), and the complication-casued extubation rate was 13.8% (n=25) while that in control group was 67.1% (n=112) and 32.9% (n=55), respectively. The differences between two groups were statistically significant (P < 0.05). Conclusion: Application of IC-ECG-guided PICC in neonates can improve the accuracy of catheter tip position and final extubation rate, and reduce the incidence of catheter-related complications.

DOI 10.11648/j.ajp.20200602.31
Published in American Journal of Pediatrics ( Volume 6, Issue 2, June 2020 )
Page(s) 178-182
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neonate, Intracavitary Electrocardiogram (IC-ECG), Peripherally Inserted Central Catheter (PICC), Catheter Tip Position

References
[1] Pittiruti M, Bertollo D, Briglia E, et al. The intracavitary ECG method for positioning the tip of central venous catheters: results of an Italian multicenter study. Journal of Vascular Access. 2012; 13 (3): 357.
[2] Rossetti F, Pittiruti M, Lamperti M, Graziano U, Celentano D, Capozzoli G. The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study. Journal of Vascular Access. 2014; 13 (3): 1-9.
[3] Wang Huaping, Yang Lixia, Shi Lan, et al. Application of intraluminal electrocardiogram combined with ultrasound in PICC localization. Nursing Practice and Research. 2016; 13 (04): 114-116.
[4] 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.
[5] Li Li, Pang BAodong, Li Yingyu, et al. Characteristics of right heart parameters in electrocardiogram of newborns with different gestational ages. China Journal of Modern Medicine. 2013 (25): 47-50.
[6] Yuan Baoyu, Zheng zheng, Xia Dongmei. Discussion on the improvement method and ideal depth of PICC tube placement. Chinese Journal of General Surgery (Electronic Edition). 2011; 5 (03): 265-266.
[7] Cales YK, Rheingans J, Steves J, Moretti M. Electrocardiogram-Guided Peripherally Inserted Central Catheter Tip Confirmation Using a Standard Electrocardiogram Machine and a Wide-Mouth Electrocardiogram Clip Compared with Traditional Chest Radiograph. Journal of the Association for Vascular Access. 2016; 21 (1): 44-54.
[8] Wu Wenli, Chen Peiyi, Song Yanling, et al. Observation on The Effect of Intracavity Electrocardiogram Technology on Head-end Positioning of PICC Catheterization in Neonates. The Journal of Practical Medicine. 2016; 32 (20): 3443-3445.
[9] Zhou L, Xua H, Xu M, Hu Y, Lou XF. An Accuracy Study of the Intracavitary Electrocardiogram (IC-ECG) Guided Peripherally Inserted Central Catheter Tip Placement among Neonates. Open Med. 2017; 12 (1): 125-130.
[10] Lu Xilie. 301 Clinical Electrocardiography. Beijing: Science and Technology Literature Press, 2010.
[11] Li Jianguo, Du Chaohui, Zhou Qing, et al. Endocavitary Electrocardiography Guided Cannulation in Placement in Placement of Central Venous Catheters. Chinese Journal of Clinical Nutrition. 2005 (01): 30-34.
[12] Gao Ling. Study for The Relationship Befaeen The Tip of PICC Position and Complication. Journal of Nurses Training. 2012; 27 (22): 2074-2075.
[13] Wu Xuhong. The Risk Factors and Nursing Intervention Method Related to PICC Complications of Newborn Baibes. Chinese Nursing Management. 2017; 17 (02): 166-171.
[14] Lou Xiaofang, Lu Hua, Li Lizhong, et al. Analysis on reason of abnormal catheter removal of PICC during NICU. Journal of Nurses Training. 2004 (09): 776-777.
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    Liu Yintian, Liao Qiuying, He Jinai, Lin Na. (2020). Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization. American Journal of Pediatrics, 6(2), 178-182. https://doi.org/10.11648/j.ajp.20200602.31

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    ACS Style

    Liu Yintian; Liao Qiuying; He Jinai; Lin Na. Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization. Am. J. Pediatr. 2020, 6(2), 178-182. doi: 10.11648/j.ajp.20200602.31

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    AMA Style

    Liu Yintian, Liao Qiuying, He Jinai, Lin Na. Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization. Am J Pediatr. 2020;6(2):178-182. doi: 10.11648/j.ajp.20200602.31

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  • @article{10.11648/j.ajp.20200602.31,
      author = {Liu Yintian and Liao Qiuying and He Jinai and Lin Na},
      title = {Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {2},
      pages = {178-182},
      doi = {10.11648/j.ajp.20200602.31},
      url = {https://doi.org/10.11648/j.ajp.20200602.31},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajp.20200602.31},
      abstract = {Objective: To compare the effects of Intracavitary Electrocardiography (IC-ECG) method and in vitro measurement for positioning the tip of Peripherally Inserted Central Catheter (PICC) in neonates, and investigate the influence of these two methods on PICC complications. Methods: Neonates who received PICC in the neonate intensive care unit of the First Affiliated Hospital of Jinan University from January 2015 to August 2019 were analyzed retrospectively. Patients were divided into two groups: the observation group with both IC-ECG method and in vitro measurement and the control group only with in vitro measurement. Chest X-ray were taken for both groups after the catheterization to confirm the catheter tip position. Statistics about catheter tip position, final extubation rate and PICC-related complications were collected and compared. Results: A total of 348 patients were enrolled (181 observation group, 167 control group). Two groups were comparable in terms of gender, gestational age, birth weight, catheterized side and vein during catheterization with no statistical significance. In the observation group, 173 (95.6%) had P-wave amplitude changes, including 4 (2.2%) were positioned at the upper 1/3 of the superior vena cava (SVC), 28 (15.5%) at the middle 1/3 of SVC, 104 (57.5%) at lower 1/3 of SVC; 38 cases (21.0%) at the right atrium or right ventricle, 7 (3.9%) at other parts, and the proportion of above situations in control group were 7 (4.2%), 15 (9.0%), 33 (19.8%), 48 (28.7%), and 47 (38.3%), respectively. The final extubation rate in the observation group was 86.2% (n=156), and the complication-casued extubation rate was 13.8% (n=25) while that in control group was 67.1% (n=112) and 32.9% (n=55), respectively. The differences between two groups were statistically significant (P  0.05). Conclusion: Application of IC-ECG-guided PICC in neonates can improve the accuracy of catheter tip position and final extubation rate, and reduce the incidence of catheter-related complications.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Study on the Effects of IC-ECG Method in Neonatal PICC Catheterization
    AU  - Liu Yintian
    AU  - Liao Qiuying
    AU  - He Jinai
    AU  - Lin Na
    Y1  - 2020/04/29
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200602.31
    DO  - 10.11648/j.ajp.20200602.31
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 178
    EP  - 182
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200602.31
    AB  - Objective: To compare the effects of Intracavitary Electrocardiography (IC-ECG) method and in vitro measurement for positioning the tip of Peripherally Inserted Central Catheter (PICC) in neonates, and investigate the influence of these two methods on PICC complications. Methods: Neonates who received PICC in the neonate intensive care unit of the First Affiliated Hospital of Jinan University from January 2015 to August 2019 were analyzed retrospectively. Patients were divided into two groups: the observation group with both IC-ECG method and in vitro measurement and the control group only with in vitro measurement. Chest X-ray were taken for both groups after the catheterization to confirm the catheter tip position. Statistics about catheter tip position, final extubation rate and PICC-related complications were collected and compared. Results: A total of 348 patients were enrolled (181 observation group, 167 control group). Two groups were comparable in terms of gender, gestational age, birth weight, catheterized side and vein during catheterization with no statistical significance. In the observation group, 173 (95.6%) had P-wave amplitude changes, including 4 (2.2%) were positioned at the upper 1/3 of the superior vena cava (SVC), 28 (15.5%) at the middle 1/3 of SVC, 104 (57.5%) at lower 1/3 of SVC; 38 cases (21.0%) at the right atrium or right ventricle, 7 (3.9%) at other parts, and the proportion of above situations in control group were 7 (4.2%), 15 (9.0%), 33 (19.8%), 48 (28.7%), and 47 (38.3%), respectively. The final extubation rate in the observation group was 86.2% (n=156), and the complication-casued extubation rate was 13.8% (n=25) while that in control group was 67.1% (n=112) and 32.9% (n=55), respectively. The differences between two groups were statistically significant (P  0.05). Conclusion: Application of IC-ECG-guided PICC in neonates can improve the accuracy of catheter tip position and final extubation rate, and reduce the incidence of catheter-related complications.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Cardiovascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Cardiovascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Nursing, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Section