Popis: |
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. |