The effect of grouth in length on PICC tip displacement in very low birth weight infants appropriate for gestational age and less than gestational age
Objective To investigate the influence of body length growth on PICC tip displacement in appropriate for gestational age infants(AGA)and younger gestational age infants(SGA)among very low birth weight infants,to compare the extent of the impact laterally to help better grasp the timing of catheter tip position monitoring.Methods A retrospective analysis was conducted of VLBW by using PICC hospitalized in NICU from January 2021 to June 2022.The VLBW were divided into 45 cases in the AGA group and 19 cases in the SGA group based on the relationship between birth weight and gestational age.The body length(Ht1)and the position of PICC tip on the day of initial catheterization,the body length(Htn)and the position of the PICC tip on the day of chest radiograph during catheterization were recorded,and the corresponding body length growth rate was calculated.The correlation between body length growth rate and PICC tip displacement was analyzed using by Spearman rank correlation analysis.Perform a simple linear regression analysis between the body length growth rate of AGA and SGA and the PICC tip displacement respectively,to construct regression models,and use covariance analysis to compare the two sets of regression lines.Results In VLBW,the vast majority of children(97.8%)in the AGA group experienced displacement,while all children in the SGA group experienced displacement,with the largest proportion of 3 vertebral bodies displaced.Spearman rank correlation analysis showed that there was a correlation between body length growth rate and PICC tip displacement in both groups(AGA group rs=-0.719,P<0.001;SGA group rs=-0.769,P<0.001).As VLBW body length increased,PICC tip displacement gradually moved away from the heart.The results of simple linear regression analysis showed that the AGA group regression model(R2=0.517,adjusted R2=0.513,F=129.487,P<0.001),the SGA group regression model(R2=0.591,R2=0.585,F=95.385,P<0.001).As the regression coeffcient test was not statistically significant,the two lines were parallel,indicating that the growth rate of length had a consistent effect on the displacement of the children in both groups,the comparison of intercepts was statistically significant(F=9.265,P=0.003),It shows that the starting point of displacement in the two groups of the infants(the location of displacement when the growth rate was zero),indicating that it is relevant whether the displacement is AGA and SGA.Conclusion As the body length of AGA and SGA in VLBW increases,the PICC tip gradually shifts away from the heart,but with the same body length growth rate,SGA causes greater catheter tip displacement.Clinically,the AGA body length growth rate of 12.4%and the SGA body length growth rate of 9.5%were important opportunities to monitor the position of the catheter tip to avoid further displacement of the catheter tip to the non-central venous,leading to related complications.
Very low birth weight infantsAppropriate for gestational ageSmall for gestational ageHeightPeripherally inserted central catheterTip position
万方数据
维普
