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Comparison of Catheter Malposition Incidence in Peripherally Inserted Central Catheters Between Left and Right Upper Limbs: A Cross‐Sectional Study

Year: 2025

Type: article

Abstract: ABSTRACT Objective This study aims to examine the effects of catheter placement site (left vs. right upper limbs) and operator experience (experienced nurses vs. trainees) on the incidence of peripherally inserted central catheter (PICC) malposition. Methods A retrospective analysis was conducted on 2451 PICC placements utilizing standardized ultrasound guidance. Malposition was characterized by the catheter tip not in the superior vena cava. In instances of catheter tip excessive insert into cardiac chambers, the distance from the catheter tip to the cavoatrial junction (CAJ) was measured. Propensity score matching (1:1) was employed to control for confounding variables such as age and gender. Results The overall malposition rate was 12.32% (302 out of 2451), with no significant difference observed between the limbs (left: 11.58% vs. right: 15.66%, p = 0.018 pre‐match; 12.66% vs. 13.70% post‐match, p = 0.181). Right‐sided placements demonstrated greater catheter penetration (30 mm vs. 16.5 mm into the right heart, p = 0.006). No significant difference in malposition rates was found between experienced nurses and trainees (p > 0.05); however, trainees required more frequent repeat punctures (22.22% vs. 5.05%, p < 0.001). Conclusions The rates of PICC malposition are similar between the left and right upper limbs when adjusted for body habitus. However, insertions on the right side pose a higher risk of deeper cardiac placement. The implementation of standardized protocols and the involvement of experienced operators can mitigate procedural complications. These findings advocate for the development of tailored measurement strategies and the enhancement of training programs.

Source: Health Science Reports

DOI: 10.1002/hsr2.71172

Authors: Lanfang Huang, Yanni Chen, Qinfei Li, Junqi Luo, Fengjiao Long, Guojie Wang

Institutions: Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University

Language: English

Topic: Central Venous Catheters and Hemodialysis

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,280