Ota Hidehito, Ide Kentaro, Watanabe Taro, Nishimura Nao, Nakagawa Satoshi
Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan.
Department of Pediatrics, The University of Tokyo, Tokyo, Japan.
Pediatr Int. 2022 Jan;64(1):e15128. doi: 10.1111/ped.15128.
It is difficult to determine the insertion length of peripherally inserted central catheters (PICCs) without fluoroscopy. The objectives of this study were to examine the relationship between the length from the anterior axillary point to the level of the carina (L ) and patient's height, and to obtain possible estimation formulas that can be considered for validation in future studies.
We retrospectively analyzed PICCs from the upper arm in the pediatric intensive care unit (PICU) between May 2017 and September 2018. We evaluated the relationship between L and the patient's height using linear regression. We also conducted simulated performance assessment of simplified formulas based on the observed relationships.
Fifty-four PICCs from the right arm and 49 from the left for patients at the median age of 1 year were analyzed. The following linear correlations between L and the patient's height were observed: 0.105 × height (cm) + 1.53 (cm) (P < 0.001, R = 0.71) from the right arm, and 0.125 × height (cm) + 1.21 (cm) (P < 0.001, R = 0.65) from the left arm. In the simulated performance assessment, with a simplified formula, [0.1 × height (cm) + 1 (cm)], 93% (50/54) of the PICCs from the right arm and 96% (47/49) from the left arm were expected to be inserted in the subclavian vein, innominate vein, or superior vena cava.
The level of the carina was correlated with the patient's height. A simplified formula, 0.1 × height (cm) + 1, seemed to perform acceptably and appeared to be worth validating in future studies.
在没有荧光透视的情况下，很难确定经外周静脉穿刺中心静脉导管（PICC）的置入长度。本研究的目的是探讨从腋前点到隆突水平的长度（L）与患者身高之间的关系，并获得可能的估算公式，以供未来研究进行验证。
我们回顾性分析了2017年5月至2018年9月期间儿科重症监护病房（PICU）中经上臂置入的PICC。我们使用线性回归评估了L与患者身高之间的关系。我们还基于观察到的关系对简化公式进行了模拟性能评估。
分析了年龄中位数为1岁患者的54根右臂PICC和49根左臂PICC。观察到L与患者身高之间存在以下线性相关性：右臂为0.105×身高（厘米）+1.53（厘米）（P<0.001，R=0.71），左臂为0.125×身高（厘米）+1.21（厘米）（P<0.001，R=0.65）。在模拟性能评估中，使用简化公式[0.1×身高（厘米）+1（厘米）]，预计右臂93%（50/54）的PICC和左臂96%（
