Evidence map›Paper›PMID 41422244›Full record

ArticleCritical care (London, England)2025

Ultrasound-guided tip location and detection of tip migration of neonatal peripherally inserted central catheters: a prospective, multicenter study (DISLOTIP study).

Fiorentino Grasso, Antonella Capasso, Pasquale Dolce, Gaetano Ausanio, Italo Bernardo, Chiara Poggi, Carlo Dani, Luca Bonadies, Eugenio Baraldi, Martino Landi and 14 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06438289 (Use of Ultrasound to Investigate Tip Dislodgment of Epicutaneous-caval Catheter), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06438289 completednot on this map

Use of Ultrasound to Investigate Tip Dislodgment of Epicutaneous-caval Catheter: a Multicentric Study

TypeobservationalSponsorFederico II UniversityRan2024 to 2024Enrolled217ConditionsMigration of Implant or Internal Device
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Fiorentino GrassoNeonatology and Neonatal Intensive Care Unit, Department of Translational Medicine, University of Naples Federico II, Naples, Italy. fiorentino.grasso89@gmail.com.
Antonella CapassoNeonatology and Neonatal Intensive Care Unit, Department of Translational Medicine, University of Naples Federico II, Naples, Italy.
Pasquale DolceBiostatistics and Clinical Trial Methodology Unit, Clinical Research Center DEMeTra, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.
Gaetano AusanioNeonatal Intensive Care Unit, 'S. Anna E S. Sebastiano' Hospital, Caserta, Italy.
Italo BernardoNeonatal Intensive Care Unit, 'S. Anna E S. Sebastiano' Hospital, Caserta, Italy.
Chiara PoggiNeonatology and Neonatal Intensive Care, Department of Mother and Child Care, Careggi University Hospital, Florence, Italy.
Carlo DaniNeonatology and Neonatal Intensive Care, Department of Mother and Child Care, Careggi University Hospital, Florence, Italy.
Luca BonadiesNeonatal Intensive Care Unit, Department of Woman's and Child's Health, University of Padua, Padua, Italy.
Eugenio BaraldiNeonatal Intensive Care Unit, Department of Woman's and Child's Health, University of Padua, Padua, Italy.
Martino LandiNeonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Barbara TomasiniNeonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Ferdinando SpagnuoloNeonatal Intensive Care Unit, "Luigi Vanvitelli" University Hospital, Naples, Italy.
Mauro CarpentieriNeonatal Intensive Care Unit, "Luigi Vanvitelli" University Hospital, Naples, Italy.
Vito D'AndreaNeonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.
Giovanni VentoNeonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario 'Agostino Gemelli' IRCCS, Rome, Italy.
Carmen Rodriguez-PerezNeonatology and Neonatal Intensive Care Unit, ASST Spedali Civili, Ospedale Dei Bambini, Brescia, Italy.
Francesco Maria RissoNeonatology and Neonatal Intensive Care Unit, ASST Spedali Civili, Ospedale Dei Bambini, Brescia, Italy.
Giovanni BaroneNeonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy.
Gina AncoraNeonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy.
Benjamim FicialNeonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Paolo BibanNeonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Mauro PittirutiDepartment of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Letizia CapassoNeonatology and Neonatal Intensive Care Unit, Department of Translational Medicine, University of Naples Federico II, Naples, Italy.
Francesco RaimondiNeonatology and Neonatal Intensive Care Unit, Department of Translational Medicine, University of Naples Federico II, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncorrect neonatal peripherally inserted central catheter (n-PICC) tip positioning and secondary migration lead to serious complications. Identifying an accurate and non-invasive tip location method is crucial. This study primarily aimed to evaluate the feasibility of ultrasound-guided n-PICC tip location in a multicenter setting. Secondary aims were to determine the incidence and timing of tip migration and to identify factors associated with migration.

methodsMulticenter, prospective, cross-sectional study conducted at 10 Neonatal Intensive Care Units from January 2024 to January 2025. Ultrasound was used to confirm initial tip placement (T0) and repeated at 60–120 min (T1), 48–72 h (T2), and 6–8 days (T3) while the neonate was maintained in a standardized position. Feasibility was defined as obtaining clear images of all protocol-specified ultrasound views. Migration was defined as a tip displacement ≥ 0.5 cm or as a location in a different vessel. To analyze the factors associated with migration, univariate and multivariable logistic regression models were used.

resultsTwo hundred nineteen n-PICCs in 205 neonates were investigated. Ultrasound tip location was feasible in 212/219 (97%) cases. Tip migration occurred in 90/207 (43%) catheters evaluated for migration. The majority of migrations (79/90, 88%) were towards the heart and frequently occurred within the first 2 h post-insertion. Intracardiac migration was significantly more common when catheters were inserted via the upper extremities or scalp (79/87, 90%) compared to those placed via the lower extremities (0/14, 0%; p = 0.001). While univariate analysis linked migration to lower body weight and insertion site, multivariable analysis confirmed only the insertion site as an independent predictor, with non-upper limb insertions showing significantly lower odds of migration compared to those distal to the elbow.

conclusionsUltrasound is a highly feasible and accurate method for n-PICC tip location. Tip migration is a frequent event, particularly towards the heart in upper limbs/scalp insertions and within the first 2 h. We recommend serial ultrasound monitoring to detect tip migration and potentially reduce catheter-related complications.

trial registrationClinicalTrials.gov Identifier: NCT06438289. Registered 24 May 2024.

Indexed as

Catheterization, Central VenousCatheterization, PeripheralForeign-Body MigrationUltrasonography, InterventionalCross-Sectional StudiesFemaleHumansInfant, NewbornIntensive Care Units, NeonatalMaleProspective StudiesUltrasonographyCatheter migrationCentral venous catheterNewbornNICUUltrasound tip location

Identifiers

PMID41422244
PMCPMC12750678

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.