Method for Determination of Peripherally Inserted Central Catheter (PICC) Insertion Length in Infants

Proportion of Successful Insertions in Mathematical Formula versus Direct Measurement for Insertion of Peripherally Inserted Central Catheter (PICC) in Neonates (PICCIN)

Status

Recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12621001565831

Enrollment

Registered

2021-11-17

Start date

2021-11-19

Completion date

Unknown

Last updated

2022-11-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

A PICC (peripherally inserted central catheter) is a catheter in which the tip resides in a central vein via percutaneous insertion from a peripheral vein. A neonatal PICC can be inserted at the patient's bedside and it can remain in place for several weeks. The small diameter of its lumen is ideal for the extremely small neonate. However, the placement and maintenance of peripheral intravenous catheters in preterm infants is difficult and can become a challenge for clinicians. The complications of PICC placement have been previously reported as infection, thrombosis, phlebitis, bleeding and misplacement. The complication rate of PICCs is associated with the location of their tips. Centrally placed catheter tips are associated with fewer complications compared with non-centrally placed catheter tips (Jumani, Advani et al. 2013). Therefore, the tip location of PICC is an important factor in reducing the complication rate of PICC. The determination of PICC insertion length traditionally depends on the direct measurement of length between two anatomical landmarks on the infant's body. In 2019, Chen et. al. introduced a mathematical formula to determine the PICC insertion length using anthropometric measurement. This study aims to recruit 72 infants less with a birth weight of less than 1500g that will be randomised into either the mathematical formula or direct measurement method in the insertion length determination. The outcomes will include the proportion of infants with appropriate PICC tip placement and rate of complication within the first two weeks post insertion. We hypothesized that determination of the length of insertion of PICC in neonates using mathematical formula based on body measurement has higher successful rate with lower rate of complication compared to direct measurement.

Interventions

For neonates randomized into intervention group, the length of PICC insertion will be based on the formula; Length (cm) = -1.45 + (0.36 x body length (cm)) All PICC will be inserted by a well-trained medical officers working in NICUs with at least one year experiences in PICC insertion. All the medical officers (MO) will be trained on the correct method to measure the length from the insertion site to the sternal notch.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Prevention

Masking

Blinded (masking used) (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

All

Age

1 Days to 12 Months

Healthy volunteers

Inclusion criteria

Infants weigh equal or less than 1500g admitted to NICU that require PICC insertion in the participating NICUs within the study the period.

Exclusion criteria

1. Congenital anomaly that is expected to interfere with study outcome as listed; -Orthopaedic problems: Arthrogryposis multiplex congenita, fixed congenital talipes equinovarus, development dysplasia of the hip (DDH), skeletal dysplasia, 2. Chromosomal aneuploidy or genetic disorders : Any recognized or unrecognized dysmorphism , i.e. Down Syndrome, Patau Syndrome, Edward Syndrome, Single gene or polygenic defects, ie: Cri-du chat, Di George syndrome, Prader Willi Syndrome etc 3. Patient with vascular anomaly 4. Hydrops fetalis

Outcome results