ArticleJournal of thoracic disease2026
Risk factors for peripherally inserted central catheter tip migration in patients undergoing thoracoscopic thoracic surgery: a retrospective cohort study.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Peripherally inserted central catheter (PICC) is widely used for perioperative intravenous therapy in thoracic surgery. Tip migration can lead to reduced drug infusion efficiency, thrombosis, and other complications. Thoracic surgery, particularly lung resection, may increase the risk of migration by altering intrathoracic pressure and mediastinal position; however, systematic studies are lacking. This study aimed to identify the incidence and independent risk factors for PICC tip migration after thoracoscopic thoracic surgery. Methods: A total of 222 patients who underwent thoracoscopic surgery and received PICC at the Department of Thoracic Surgery of The First Hospital of Lanzhou University between January 2025 and January 2026 were retrospectively included. PICC tip migration was defined as a deviation of the catheter tip from its initial position of >2 cm on postoperative chest X-ray, with persistence on subsequent examination and no spontaneous repositioning. Demographic variables, surgical procedure, side of PICC insertion, and other covariates were collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for PICC tip migration. Results: PICC tip migration occurred in 38 of the 222 patients, yielding an incidence of 17.12%. Multivariate logistic regression analysis showed that lung resection [odds ratio (OR) =8.736, 95% confidence interval (CI): 2.303-33.143, P=0.001] and right-side insertion (OR =3.697, 95% CI: 1.375-9.943, P=0.01) were independent risk factors for PICC tip migration. Consistency of intraoperative lateral decubitus position with the insertion side and severe postoperative cough were not statistically significant in the multivariate analysis (both P>0.05). Conclusions: The incidence of PICC tip migration is relatively high in patients undergoing thoracoscopic thoracic surgery. Lung resection and right-side insertion are independent risk factors. For patients scheduled for lung resection, preferential use of the left arm for PICC insertion may be considered. For those requiring right-side insertion, intensified postoperative chest X-ray monitoring is advised. However, these suggestions require prospective validation with outcome-based endpoints.
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