Peripherally inserted central venous lines versus central lines in surgical newborns--a comparison

Area of Science:

• Neonatal Intensive Care
• Vascular Access Devices
• Pediatric Surgery

Background:

• Central lines (CL) and peripherally inserted central lines (PICL) are crucial for intravenous access in neonates.
• Evaluating the comparative efficacy and safety of these devices is essential for optimal patient care.

Purpose of the Study:

• To compare the insertion characteristics, utilization, lifespan, and complication rates of CL and PICL in neonatal surgical patients.
• To determine the preferred method for prolonged intravenous access in this population.

Main Methods:

• A prospective study was conducted in a Neonatal Surgical Intensive Care Unit.
• Data on insertion attempts, procedure time, catheter dwell time, dressing changes, complications, and removal reasons were collected for CL and PICL.
• Statistical analysis using Pearson chi-square/t-test was performed to compare outcomes.

Main Results:

• PICL insertions (n=60) showed significantly fewer attempts, shorter procedure times, and fewer dressing changes compared to CL insertions (n=32).
• Overall complication rates were significantly lower for PICL (p=0.002).
• PICLs had a longer duration of use and fewer early removals (11.5%) than CLs (37.5%).

Conclusions:

• Peripherally inserted central lines (PICL) are a safe, effective, and reliable option for prolonged IV access in newborns.
• PICLs exhibit a lower incidence of complications during insertion and maintenance compared to CLs.
• PICLs should be considered for routine use in neonatal surgical patients requiring extended intravenous therapy.