eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution:China Association for Science and Technology
Sponsor:Chinese Nursing Association
Special Planning—Nursing Care of Critically Ill Children and Newborns

Application of positioning aids in positioning the tip of PICC in neonates

  • ZHOU Lianjuan ,
  • ZHU Jihua ,
  • ZHOU Hongqin ,
  • LOU Xiaofang ,
  • ZHU Haihong ,
  • YUAN Tianming ,
  • PAN Jiarong ,
  • XU Hongzhen
Expand

Received date: 2021-03-04

  Online published: 2022-01-17

Abstract

Objective To evaluate the application effect of self-designed positioning aids in neonatal PICC tip localization. Methods 247 neonates with PICC catheterize from January 2018 to December 2020 in the neonatal department of a tertiary hospital in Zhejiang Province were selected as the experimental group,and 180 neonates with PICC catheterize from January 2016 to December 2017 were selected as the control group. During PICC puncture,intravenous electrocardiogram was used to guide tip positioning in both groups,and the position of the tip was verified by X-ray after successful fixation. During positioning,positioning aids were used in the experimental group to fix the position,and the standard neonatal position was used in the control group. The success rate of the first tip localization,the time of catheterization localization and the incidence of ectopic in X-ray verification were compared between the two groups. Results In the experimental group,232 cases(93.9%) were successfully located for the first time,which was significantly higher than 144 cases(80.0%) in the control group. The positioning time of the expe-rimental group was (3.06± 0.31) min,which was lower than that of the control group (5.33± 1.23) min,and the difference was statistically significant(P< 0.05). The incidence of ectopic location in experimental group(5.67%) was significantly lower than that in control group(13.89%). Conclusion The use of positioning aids can improve the accuracy of ECG positioning and X-ray positioning results,improve the work efficiency of nurses,and reduce PICC ectopic and X-ray exposure in children.

Cite this article

ZHOU Lianjuan , ZHU Jihua , ZHOU Hongqin , LOU Xiaofang , ZHU Haihong , YUAN Tianming , PAN Jiarong , XU Hongzhen . Application of positioning aids in positioning the tip of PICC in neonates[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022 , 3(1) : 47 -51 . DOI: 10.3761/j.issn.2096-7446.2022.01.008

References

[1] Infusion Nurses Society.Infusion nursing standards of practice[J]. J Infus Nurs,2006,29(1 suppl):1-92.
[2] 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]. J Vasc Access,2015,16(2):137-143.
[3] 张莎,朱玉欣,刘鹏元,等. 新生儿腔内心电图定位PICC尖端位置的临床观察[J]. 护士进修杂志,2016,31(7):651-653.
Zhang S,Zhu YX,Liu PY,et al.Observation of peripherally inserted central venous catheters tip positioning by newborn chamber electrocardiogram[J]. J Nurs Train,2016,31(7):651-653.
[4] Elli S,Cannizzo L,Marini A,et al.Evaluation of tip location reliability of intraprocedural ECG vs. chest Xrays in PICC placement[J]. Assist Inferm Ric,2016,35(4):174-179.
[5] Zhou LJ,Xu HZ,Liang JF,et al.Effectiveness of intracavitary electrocardiogram guidance in peripherally inserted central catheter tip placement in neonates[J]. J Perinat Neonatal Nurs,2017,31(4):326-331.
[6] Zhou LJ,Xua HZ,Xu MF,et al.An accuracy study of the intracavitary electrocardiogram(IC-ECG) guided peripherally inserted central catheter tip placement among neonates[J]. Open Med(Wars),2017,12:125-130.
[7] 周莲娟,徐红贞,徐美芳,等. 新生儿下肢静脉PICC头端心电图定位方法的临床应用[J]. 中国实用护理杂志,2017,33(16):1246-1249.
Zhou LJ,Xu HZ,Xu MF,et al.Clinical application of electrocardiogram(ECG) localization method for PICC head of lower limb vein in neonates[J]. Chin J Pract Nurs,2017,33(16):1246-1249.
[8] Forauer AR,Alonzo M.Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity[J]. J Vasc Interv Radiol,2000,11(10):1315-1318.
[9] Bashir RA,Callejas AM,Osiovich HC,et al.Percutaneously inserted central catheter-related pleural effusion in a level Ⅲ neonatal intensive care unit:a 5-year review(2008-2012)[J]. J Parenter Enteral Nutr,2017,41(7):1234-1239.
[10] Sneath N.Are supine chest and abdominal radiographs the best way to confirm PICC placement in neonates?[J]. Neonatal Netw,2010,29(1):23-35.
[11] 陈琼,李颖馨,胡艳玲,等. 新生儿经外周置入中心静脉导管操作及管理指南(2021)[J]. 中国当代儿科杂志,2021,23(3):201-212.
Chen Q,Li YX,Hu YL,et al.Operation and management guidelines for peripherally inserted central catheter in neonates(2021)[J]. Chin J Contemp Pediatr,2021,23(3):201-212.
[12] Hansen,Anne R,Eichenwald,et al. Cloherty and Stark's man-ual of neonatal care[M]. Lippincott Williams & Wilkins,2016.
[13] 马晓路,李如意. 重危新生儿的急症监护[M]. 杭州:浙江大学出版社,2009:5-11.
Ma XL,Li RY.Acute care of critically ill neonates[M]. Hangzhou:Zhejiang University Press,2009:5-11.
[14] 程田志,刘荣志,马丽. 新生儿经皮股静脉穿刺下腔静脉置管术的应用[J]. 实用儿科临床杂志,2006,21(14):893,897.
Cheng TZ,Liu RZ,Ma L. Applied anatomy for neonate femoral vein puncture to inferior vena cava[J]. J Appl Clin Pediatr,2006,21(14):893,897.
Outlines

/