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Standard Versus Long Peripheral Catheters for Multiday IV Therapy: A Randomized Controlled Trial.
Kirby R Qin1,2,3, Nicholas Ensor1,2,3, Richard Barnes4
1Departments of Paediatric Surgery and.
Pediatrics
|January 15, 2021
Summary
Long peripheral catheters (LPCs) significantly reduce failure rates and the number of catheters needed for prolonged intravenous therapy in children compared to standard peripheral intravenous catheters (PIVCs). LPCs are recommended as a first-line option for pediatric patients requiring extended IVT.
Area of Science:
- Pediatric critical care
- Vascular access devices
- Clinical trial methodology
Background:
- Standard peripheral intravenous catheters (PIVCs) in children are often unreliable for intravenous therapy (IVT) lasting longer than 48 hours.
- Frequent PIVC failure necessitates multiple catheter insertions, increasing patient discomfort and healthcare costs.
- Longer peripheral catheters (LPCs) may offer improved reliability for extended IVT in pediatric populations.
Purpose of the Study:
- To evaluate the efficacy of long peripheral catheters (LPCs) versus standard peripheral intravenous catheters (PIVCs) in reducing catheter failure.
- To determine if LPCs decrease the total number of catheters required for multiday intravenous therapy in children.
- To compare the lifespan and success rates of LPCs versus PIVCs in pediatric patients.
Main Methods:
- An open-label randomized controlled trial was conducted involving children aged 1 to 17 years requiring postoperative IVT for over 48 hours.
- Participants were randomized to receive either a standard 2.5-cm 22G PIVC or an 8-cm 22G LPC.
- Catheter failure rates, reasons for failure (e.g., infiltration), catheter lifespan, and the number of catheters needed to complete therapy were assessed.
Main Results:
- Catheter failure was significantly higher with PIVCs (66.7%) compared to LPCs (19.4%).
- LPCs demonstrated a superior lifespan (median 4.7 days vs. 3.5 days for PIVCs).
- Children receiving LPCs were twice as likely to complete their therapy with a single catheter (80.6% vs. 38.9% for PIVCs).
Conclusions:
- Long peripheral catheters (LPCs) are more reliable than standard PIVCs for children requiring prolonged intravenous therapy.
- The use of LPCs significantly reduces catheter failure rates and the overall number of catheters needed.
- LPCs should be considered the preferred first-line device for peripheral vascular access in pediatric patients undergoing extended IVT.
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