Network Meta-analysis of the accuracy and safety of different PICC tip positioning methods in catheter placement for infants and young children
WU Jiaming
GUO Xin
DU Jiajia
HU Xue
PENG Junjie
LI Yunchuan
WU Yuanfang
Abstract：Objective:To investigate the accuracy and safety of different peripherally inserted central catheter(PICC)tip positioning methods during catheter placement in infants and young children using network Meta-analysis.Methods:Randomized controlled trials(RCTs)comparing the accuracy and safety of PICC tip positioning methods in infants and young children were systematically searched across 8 Chinese and English databases from their inception to May 16,2023.Two researchers independently performed literature screening,data extraction,and risk assessment.Network Meta-analysis was conducted using Stata 14.0 and the Gemtc package.Results:Twelve studies were included,involving 1 171 infant cases and 8 positioning methods.The network Meta-analysis revealed that intracavitary electrocardiogram(IC-ECG)and echocardiographic positioning methods demonstrated the highest accuracy and safety for PICC tip positioning in infants and young children.Among traditional body surface measurement methods,the approach measuring from the puncture site to the sternoclavicular joint plus an additional 0.5～1.0 cm was optimal.Conclusions:Current evidence indicates that IC-ECG and echocardiographic positioning methods provide the best clinical efficacy in terms of accuracy and safety for PICC tip positioning in infants and young children.For traditional body surface measurements,the method adding 0.5～1.0 cm from the puncture site to the sternoclavicular joint is recommended.However,future studies require more large-sample,multicenter,high-quality RCTs to establish a more stable network model.
Keywords：peripherally inserted central cathetertip positioningaccuracysafetynetwork Meta-analysis
Publication Date：2025-03-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1002-1006 )