Real-time point-of-care ultrasound (POCUS) for neonatal peripherally inserted central catheter (nPICC) tip confirmation in a tertiary neonatal unit—a cohort study
Javed, Rashida Mahadev, Kanwal Collis, Victoria Dileep, Dhanwanti Jalal, Muhammad Saif Abbey, Steven Madawala, Pri Noureldein, Mona Gowda, Harsha
Javed, Rashida
Mahadev, Kanwal
Collis, Victoria
Dileep, Dhanwanti
Jalal, Muhammad Saif
Abbey, Steven
Madawala, Pri
Noureldein, Mona
Gowda, Harsha
Abstract
Aim
To evaluate the impact of real-time point-of-care ultrasound (POCUS) for confirming neonatal peripherally inserted central catheter (nPICC) tip position compared to routine X-ray-based assessment.
Methods
Single-centre cohort study from May 2022 to July 2024, conducted at a tertiary neonatal intensive care unit in the UK.
Results
First-attempt optimal tip position was higher with POCUS at 70.1% (47/67) versus 52.8% (47/89) in the non-POCUS group (P = .042) but was not significant after adjustment (adjusted odds ratio [aOR] 0.42; 95% confidence interval [CI]: 0.09-1.54; P = .224). POCUS significantly increased the odds of requiring a single X-ray (aOR = 8.4; 95% CI: 2.24-42.10; P = .003). Radiation exposure and X-ray-associated costs were significantly lower in the POCUS group (P < .001). Catheter line-associated bloodstream infection (CLABSI) rates were lower in the POCUS group (2.9% vs 5.6%), though not statistically significant.
Conclusions
Real-time POCUS might improve first-attempt nPICC placement, reduce the need for repositioning and X-rays, lower radiation exposure and reduce cost. It represents a feasible and potentially cost-effective alternative to X-ray confirmation and merits consideration for routine use in neonatal care.
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Date
2026-02-21
Type
Article
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Citation
Javed R, Mahadev K, Collis V, Dileep D, Jalal MS, Abbey S, Madawala P, Noureldein M, Gowda H. Real-time point-of-care ultrasound (POCUS) for neonatal peripherally inserted central catheter (nPICC) tip confirmation in a tertiary neonatal unit: a cohort study. J Neonatol. 2026;0(0). doi:10.1177/09732179261424699.