Validation of the peripherally inserted central venous catheter insertion length prediction formula using height in children

Abstract Background Placing the tip of the peripherally inserted central catheter ( PICC ) in the appropriate range is important, but most difficult without fluoroscopy. The aim of this study was to test the validity of the PICC insertion length prediction formula “length from anterior axillary point to appropriate PICC tip position = height (cm) × 0.1 + 1 (cm)” Methods This study retrospectively compared PICCs inserted through the upper arm in a pediatric intensive care unit before (the No‐formula group, May 2017–September 2018) and after (the Formula group, May 2021–December 2021). We excluded PICCs inserted in patients older than 15 years of age and those with anatomical abnormalities or diseases, or PICCs inserted without using the formula in the Formula group. The primary outcome was the proportion of PICCs with appropriate tip positions (superior vena cava or subclavian vein) visualized on chest radiographs immediately after insertion. Results There were 148 PICCs in the No‐formula group and 47 PICCs in the Formula group for the primary analysis. Appropriate tip position was observed significantly more often in the Formula group (98%, 46/47) compared to the No‐formula group (65%, 96/148) ( p < 0.001). Although there were no shallow PICCs , PICC tips in the subclavian vein were more frequent in the Formula group (26% vs. 9%, p = 0.012). Conclusions The PICC insertion length prediction formula could reduce excessive deep tip positioning, but further measures are required to enhance tip placement in the superior vena cava.