A Correlation Analysis Of Weight Gaining Ration And PICCs Tip Position Migration In Very Low Birth Weight Neonates

Objective:To investigate the correlation of PICC tip position migration and weight gaining ration in very low birth weight infants.Method:We performed a retrospective study of very low birth weight infants in NICU who had a PICC inserted between January 1,2015,and August 31,2016.We recorded the tip positions on plain radiographs,calculated the position change and weight gaining ration on plain radiographs and used Spearman regression models to assess the tips position migration with the weight gaining ration.Results:A total of 57 cases of very low birth weight infants included in the study.246 X-ray films of chest radiography for the first time day weight was 0.6-1.46(1.06±0.25)kg,age was 1-12(7.1±6.1)d.The last time for plain radiographs after the catheter(24 + 9.1)d;weight growth rate of 11.8%～114.8%,an average of 45.8%±27.3%.All patients with PICC catheter tip position changed,75%of which appeared to have been migrated more than 2 vertebrae,above 50%,there were 3 vertebral migration,median migration was (2.5±1.5)vertebrae.The distances of the catheter tip migration were correlated with the rates of weight gain,with an approximate 2,and 3 and 4 vertebrae migration of the tip of PICC catheter corresponding to a weight gain rate of about 40%,70%and 100%. The correlation coefficient between PICC tip position migration and weight gaining ration is about-0.7(P<0.01),but have a little difference according to peripheral insert vein.Conclusions:Our data suggest that weight gaining is an important risk factor for PICC migration in very low birth weight infants.Considering the initial placement position,a significant increase in the risk of malposition after 40%,70%body weight gain ration require PICC tip position assessment by radiographs.After 100%body weight gain ration may warrant replacement if intravascular accessory beyond that.Peripheral insert position PICC,which is easy to be affected by bone growth and limb movement,needs to improve the frequency of catheter localization.