Application Value of Bedside Ultrasound in the Positioning of PICC Tips in Preterm Infants

Abstract

Objective To investigate the application value of bedside ultrasound in the localization of the tip of a Peripherally Inserted Central Catheter (PICC) in preterm infants. Methods 52 preterm infants underwent bedside ultrasound and bedside X-ray examination. Observing the position of the catheter tip, and using the bedside X-ray positioning as the gold standard. Statistics of the incidence of PICC tip normal position and ectopic position showed by bedside ultrasound, and comparing the difference between the results of bedside ultrasound and bedside X-ray. Calculating the accuracy, sensitivity, and specificity of ultrasound in diagnosing the tip position, and the length of the inlet and withdrawal tubes of the ectopic catheter was observed and calculated by ultrasound and down-regulated to the appropriate position under ultrasound guidance. Results The display rate of catheter tip by bedside color Doppler ultrasound was 98.0%, and the accuracy rate of tip position was 90.2%. There was no significant difference compared with bedside X-ray (P = 0.375), and the tip position of the two examination methods was highly consistent (Kappa = 0.769, P<0.001). The sensitivity of diagnosing tip ectopy was 76.5% and the specificity was 97.1%, and the success rate of ectopic catheters in ultrasound-guided downsetting was 100%. Conclusion Bedside ultrasound accurately show the position of the catheter tip and guide the entry and withdrawal of ectopic catheter, with high sensitivity and specificity, which has high value of clinical promotion.