فهرست نشریات علمی دسترسی آزاد ایران

Background: Peripherally inserted central catheters (PICCs) are critical vascular devices routinely used in neonatal intensive care units (NICUs) to provide essential intravenous access for critically ill newborns. Accurate placement of the catheter tip is crucial for preventing complications and ensuring therapeutic efficacy. Following measurement for insertion and completion of the procedure, verification of the catheter tip location is mandatory.Objectives: This study aims to compare the conventional and Rangel & Dorea measurement methods for PICC insertion regarding the need for catheter withdrawal to achieve proper tip placement.Methods: This comparative observational cross-sectional pilot study was conducted in the Neonatal Intensive Care Unit of a university-affiliated hospital in Rio de Janeiro, Brazil, from December 2022 to June 2024. Sampling was consecutive, including hospitalized newborns with an indication for PICC insertion via the upper limb. A total of 19 newborns met the eligibility criteria and were included. The data collection instrument was a structured form capturing participant characteristics, procedure-related variables, and both conventional and Rangel & Dorea measurements. Catheters were initially inserted using the conventional method; the Rangel and Dorea measurement was then performed externally by researchers. The primary outcome was the requirement for catheter withdrawal following radiological evaluation.Results: Among cases requiring catheter withdrawal to achieve proper tip placement, 7 (71.4%) demonstrated that the length retracted was equal to or exceeded the measurement suggested by the Rangel and Dorea method.Conclusion: These preliminary findings indicate that the Rangel and Dorea method may offer a more precise estimation of the optimal catheter length compared to the conventional approach. Although the results suggest potential benefits in improving tip placement accuracy, further studies involving larger and more heterogeneous neonatal populations are required to validate these findings.