Peripherally inserted central catheter in neonates: A safe and easy insertion technique

Area of Science:

• Neonatal intensive care
• Vascular access devices
• Pediatric surgery

Background:

• Peripherally inserted central catheters (PICCs) are crucial for neonatal care.
• Insertion of small-caliber (2-French) PICCs in neonates is technically challenging.
• Existing methods may require specialized equipment or complex modifications.

Purpose of the Study:

• To introduce and evaluate a novel, simplified technique for inserting 2-French PICCs in neonates.
• To assess the safety and efficacy of this new insertion method.
• To determine the feasibility of using modified commercial products for neonatal PICC placement.

Main Methods:

• A retrospective review of 32 neonates who received 2-French PICCs between November 2010 and November 2014.
• The new technique involved advancing a 24-gauge peripheral venous cannula through a half-peeled 20-gauge introducer cannula.
• Data collected included success rate, number of attempts, duration of catheterization, and complications.

Main Results:

• The technique achieved a high success rate of 97% (32/33 PICCs placed).
• Most insertions (88%) were successful on the first attempt.
• The long saphenous vein was the most common access site (87%), with a mean catheter dwell time of 10.3 days and only two minor bleeding complications.

Conclusions:

• The novel technique provides an easy and safe method for 2-French PICC insertion in neonates.
• This approach is accessible to healthcare providers skilled in standard peripheral venous access.
• The technique offers a practical solution for neonatal vascular access without requiring modified commercial products.