Long peripheral catheters in neonates: filling the gap between short peripheral catheters and epicutaneous-caval catheters?

Abstract

Introduction: Non-critically ill neonates at times require venous access to provide peripherally compatible infusions for a limited period (more than 3 days). In such a situation, short peripheral cannulas are not appropriate as their average duration is about 2 days, while—on the other hand—epicutaneous-caval catheters may be too invasive. In these patients, insertion of long peripheral cannulas may be an effective option. Methods: In this observational retrospective study, we revised all “long” peripheral catheters (4 and 6 cm long) inserted by direct Seldinger technique in our neonatal intensive care unit when peripheral venous access was required for more than 3 days. Results: We inserted 52 2Fr polyurethane catheters, either 4 cm long ( n = 25) or 6 cm long ( n = 27) in 52 patients. Mean dwelling time was 4.17 days (range 1–12). Most devices were inserted in the cephalic vein ( n = 18, 35%), and the rest in the saphenous vein ( n = 11, 21%) and other superficial veins. There was no significant correlation between the duration of the device and type of infusion ( p  = 0.40). The main complications were infiltration ( n = 16, 31%) and phlebitis ( n = 8, 15%). The rate of removal due to complications was significantly higher ( p < 0.01) in neonates with bodyweight <2000 g at the time of insertion. Conclusion: In our experience, 2 Fr 4–6 cm long peripheral catheters may be a valid option for neonates requiring peripherally compatible infusions for more than 3 days. The limits of this study are the necessity of training in the technique of insertion and the small size of our sample. The longest dwell was observed in neonates weighing >2000 g at the time of LPC insertion.