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Determining the Position of Peripherally-inserted Central Catheter tips in Neonates: A Review of Common Methods during the Last Two Decades

Document Type : original article

Authors

1 Assistant professor, Neonatal Health Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Professor, Division of Neonatology, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

3 Assistant professor, Department of Pediatrics, Division of Pediatric Cardiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

4 Professor, Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Peripherally Inserted Central Catheters (PICCs) are used for providing intravenous therapy to premature neonates. There are different intra- or post-procedural techniques to confirm line-tip placement to decrease the potential complications. The present study provides a literature review of common methods developed for the detection of PICC tip positions over the last two decades.
Methods: The literature search was conducted in various databases without language restrictions for all terms related to PICC and its tip position evaluation methods including plain radiographs, fluoroscopy, ultrasonographic detection, digital imaging, computed radiography, and intracavitary/trans-esophageal and thoracic electrocardiographic monitoring.
Results: Among the primary 172 articles, 52 of them met the inclusion criteria and were included in the study. Comparing the methods, it was found that ultrasound should be a complement to, rather than a replacement for, x-rays for PICC placement and CTP confirmation. When the catheter tip is close to the heart, Tn-ECHO should be replaced with x-rays.
Conclusion: Considering advantages and disadvantages of each method, the choice of the most appropriate method for examining the catheter tip depends on the patient's condition, available facilities, and the decision of the physician.

Keywords

References
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Journal of Pediatric Perspectives
Volume 12, Issue 2
February 2024
Pages 18573-18585
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