Critical distance and influencing factors of tracheal carina in predicting the optimal tip position of PICC
WANG Juan
LIU Yongshi
CHEN Min
ZHANG Wei
LEI Pei
YIN Yuhuan
Abstract：Objective To explore the critical distance of tracheal carina for predicting the optimal tip position of peripherally inserted central catheter (PICC) and its influencing factors. Methods This study was a retrospective study. Data on chest CT and chest X-ray images of patients who underwent PICC placement at Tangdu Hospital, Air Force Medical University from August 2020 to October 2023 were collected. The receiver operating characteristic (ROC) curve was used to predict the critical distance between the tracheal carina and the optimal tip position of PICC, which is the cavoatrial junction (CAJ). Multiple linear regression analysis was used to identify the influencing factors of the distance between the tracheal carina and CAJ. Results A total of 2,100 patients were included, of whom 893 (42.52%) had their PICC tips located at the CAJ. The average distance between the tracheal carina and CAJ was (3.30±0.42) cm. The ROC curve showed that the optimal distance between the tracheal carina and CAJ was 2.50–3.98 cm. Multiple linear regression analysis showed that gender (B = -0.134, 95% CI: -0.188 to -0.081) and BMI = 18.5–23.9 kg/m² (B = -0.017, 95% CI: -0.034 to -0.001), and BMI ≥ 24.0 kg/m² (B = -0.063, 95% CI: -0.077 to -0.048) were influencing factors of the distance between the tracheal carina and CAJ. Conclusion The optimal critical distance between the tracheal carina and CAJ is 2.50–3.98 cm, and gender and BMI are influencing factors of the optimal distance between the tracheal carina and CAJ, which can provide reference for accurately determining the ideal tip position of PICC on chest radiographs in clinical practice.
Keywords：Peripherally inserted central catheterTracheal carinaOptimal tip positionCritical distance
Publication Date：2025-10-25
Online Publishing Date：2025-11-26(First online date of this platform, not the publication date of the document)
Pages：4( 544-547 )